Provider Demographics
NPI:1598148736
Name:KNOXVILLE ENDOCRINOLOGY CLINIC, LLC
Entity Type:Organization
Organization Name:KNOXVILLE ENDOCRINOLOGY CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HASSAN
Authorized Official - Middle Name:FOUAD
Authorized Official - Last Name:NADROUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-986-9151
Mailing Address - Street 1:108 LOVELL RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-1903
Mailing Address - Country:US
Mailing Address - Phone:865-288-7776
Mailing Address - Fax:865-288-7775
Practice Address - Street 1:108 LOVELL RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-1903
Practice Address - Country:US
Practice Address - Phone:865-288-7776
Practice Address - Fax:865-288-7775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-07
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000038206261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty