Provider Demographics
NPI:1467649749
Name:MARY DILLON, MD, PLLC
Entity Type:Organization
Organization Name:MARY DILLON, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:E
Authorized Official - Last Name:DILLON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-541-1726
Mailing Address - Street 1:1901 W CLINCH AVE
Mailing Address - Street 2:STE 301E
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37916-2307
Mailing Address - Country:US
Mailing Address - Phone:865-541-3600
Mailing Address - Fax:865-541-2352
Practice Address - Street 1:1901 W CLINCH AVE
Practice Address - Street 2:STE 301E
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37916-2307
Practice Address - Country:US
Practice Address - Phone:865-541-3600
Practice Address - Fax:865-541-2352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN37897208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty