Provider Demographics
NPI:1285832964
Name:KUPFNER, JOHN GREGORY (MD)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:GREGORY
Last Name:KUPFNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1451 DOWELL SPRINGS BLVD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-2441
Mailing Address - Country:US
Mailing Address - Phone:865-374-7123
Mailing Address - Fax:865-374-7129
Practice Address - Street 1:1451 DOWELL SPRINGS BLVD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-2441
Practice Address - Country:US
Practice Address - Phone:865-970-9800
Practice Address - Fax:865-374-7129
Is Sole Proprietor?:No
Enumeration Date:2007-07-05
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012414642084P0800X
TN460262084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1521350Medicaid
TN1521350Medicaid