Provider Demographics
NPI:1346544640
Name:SENTER DIVERSIFIED HEALTH SYSTEMS PLLC
Entity Type:Organization
Organization Name:SENTER DIVERSIFIED HEALTH SYSTEMS PLLC
Other - Org Name:KNOXVILLE INTEGRATETD HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RILEY
Authorized Official - Middle Name:S
Authorized Official - Last Name:SENTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-934-2655
Mailing Address - Street 1:9051 EXECUTIVE PARK DR
Mailing Address - Street 2:SUITE 401
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4606
Mailing Address - Country:US
Mailing Address - Phone:865-934-2655
Mailing Address - Fax:865-934-2662
Practice Address - Street 1:9051 EXECUTIVE PARK DR
Practice Address - Street 2:SUITE 401
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4606
Practice Address - Country:US
Practice Address - Phone:865-934-2655
Practice Address - Fax:865-934-2662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-29
Last Update Date:2010-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9519207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction MedicineGroup - Single Specialty