Individual
JOSEPH TRENT ELLENBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2121 HIGHLAND AVE, KNOXVILLE, TN 37916-1111
(865) 525-2640
Mailing address
5201 CATALINA RD, KNOXVILLE, TN 37918-4510
(601) 502-7410
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
2640
TN
207R00000X
Internal Medicine Physician
2640
TN
208000000X
Pediatrics Physician
2640
TN
208000000X
Pediatrics Physician
T-2304
MS
Other
Enumeration date
07/01/2010
Last updated
06/27/2016
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