Unknown Individual – Specialist, NPI 1063416618
Specialist
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
628, Smithview Drive, Maryville, Blount County, Tennessee, 37803, United States
MARYVILLE, TN 378036100
Phone: (865) 984-7012
Fax: (865) 584-3892
Type: Location
1124, East Weisgarber Road, Timbercrest, Knoxville, Knox County, Tennessee, 37909, United States
STE 104
KNOXVILLE, TN 379092686
Phone: (865) 584-0905
Fax: (865) 584-3892
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 37803)
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