Individual
DONALD T. ELLENBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2121 HIGHLAND AVE, KNOXVILLE, TN 37916-1111
(865) 525-2640
(865) 525-9536
Mailing address
2121 HIGHLAND AVE, KNOXVILLE, TN 37916-1111
(865) 525-2640
(865) 525-9536
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
3958
TN
208000000X
Pediatrics Physician
31722
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15689
BCBS OF TN
TN
05
—
3188882
—
TN
01
—
602002950
CARITEN
TN
Enumeration date
10/03/2006
Last updated
02/17/2025
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