Individual
KELLY ROUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
501 20TH ST, SUITE 503, KNOXVILLE, TN 37916-1809
(865) 541-1750
(865) 541-1751
Mailing address
501 20TH ST, SUITE 503, KNOXVILLE, TN 37916-1809
(865) 541-1750
(865) 541-1751
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
1646
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3304318
—
TN
Enumeration date
06/21/2006
Last updated
08/26/2020
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