Organization
KNOXVILLE OMNICARE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN ALEXANDER UNGER M.D. (SOLE MEMBER, FOUNDER)
(865) 934-8385
Entity
Organization
Contact information
Practice address
1924 ALCOA HWY, KNOXVILLE, TN 37920-1511
(865) 305-5510
Mailing address
1201 SOUTHBREEZE CIR, KNOXVILLE, TN 37919-8441
(865) 934-8385
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
49026
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10308I6537
MEDICARE ID
TN
Enumeration date
03/23/2015
Last updated
03/23/2015
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