Provider Demographics
NPI:1326083221
Name:WOMEN'S PHYSICIANS OF KNOXVILLE, PC
Entity Type:Organization
Organization Name:WOMEN'S PHYSICIANS OF KNOXVILLE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:K
Authorized Official - Last Name:MOSS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-521-4900
Mailing Address - Street 1:7420 BELLINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-8183
Mailing Address - Country:US
Mailing Address - Phone:865-769-8126
Mailing Address - Fax:
Practice Address - Street 1:939 EMERALD AVE
Practice Address - Street 2:SUITE 901
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917-4502
Practice Address - Country:US
Practice Address - Phone:865-521-4900
Practice Address - Fax:865-521-4999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD39160207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3333707Medicaid
H33431Medicare UPIN
TN3333707Medicare ID - Type Unspecified