Individual
KETAN S HIRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
9333 PARK WEST BLVD, KNOXVILLE, TN 37923-4341
(865) 531-4600
Mailing address
1275 DICK LONAS RD, STE 101, KNOXVILLE, TN 37909-2604
(865) 584-4747
(865) 584-1363
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
1422
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3307571
—
TN
01
—
P00005782
RR MEDICARE PIN
TN
Enumeration date
06/19/2006
Last updated
12/13/2018
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