Provider Demographics
NPI:1407933658
Name:ROLLHAUSER, CARLOS A (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:A
Last Name:ROLLHAUSER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 440395
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37244-0395
Mailing Address - Country:US
Mailing Address - Phone:865-530-6570
Mailing Address - Fax:865-305-6576
Practice Address - Street 1:1928 ALCOA HIGHWAY
Practice Address - Street 2:B100
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920
Practice Address - Country:US
Practice Address - Phone:865-305-6570
Practice Address - Fax:865-305-6576
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD37059207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4054727OtherBCBS
TN3880627Medicare PIN
TN4054727OtherBCBS
TNP00167485Medicare PIN