Individual
FRED A. HURST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4117 E EMORY RD, KNOXVILLE, TN 37938-4229
(865) 922-2121
Mailing address
1225 E WEISGARBER RD, SUITE 200, KNOXVILLE, TN 37909-2604
(865) 584-4747
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
08260
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110136880
RR MEDICARE PIN
TN
05
—
3155461
—
TN
Enumeration date
06/19/2006
Last updated
03/21/2014
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