Organization
SMOKEY MOUNTAIN DIAGNOSTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF TJADER (OWNER)
(865) 671-6637
Entity
Organization
Contact information
Practice address
710 MABRY HOOD RD, KNOXVILLE, TN 37932-2661
(865) 671-6637
Mailing address
710 MABRY HOOD RD, KNOXVILLE, TN 37932-2661
(865) 671-6637
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3791637
MEDICARE
TN
Enumeration date
09/27/2006
Last updated
01/14/2008
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