Individual
RICHARD ANGELO ANTONUCCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7551 DANNAHER WAY, POWELL, TN 37849-4029
(865) 637-9330
(865) 859-7222
Mailing address
726 HAMPTON ROADS DR, KNOXVILLE, TN 37934-4071
(865) 675-1209
(865) 675-1109
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
MD0000017010
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3021999
—
TN
01
—
4082085
BLUE CROSS BLUE SHIELD
TN
Enumeration date
07/26/2005
Last updated
10/13/2015
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