Individual
JANICE WALKER FILLMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
501 20TH ST, KNOXVILLE, TN 37916-1863
(865) 546-8040
(865) 541-2787
Mailing address
501 20TH ST, SUITE 606, KNOXVILLE, TN 37916-1809
(865) 546-8040
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
15726
TN
207R00000X
Internal Medicine Physician
15726
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050011297
MCRR
TN
01
—
100020587
PHP TENNCARE
TN
01
—
3028754
BLUECARE
TN
Enumeration date
01/06/2006
Last updated
09/23/2010
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