Provider Demographics
NPI:1619139383
Name:KHANNA, RITU (MD 47959)
Entity Type:Individual
Prefix:
First Name:RITU
Middle Name:
Last Name:KHANNA
Suffix:
Gender:F
Credentials:MD 47959
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1932 ALCOA HWY
Mailing Address - Street 2:SUITE C460
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920
Mailing Address - Country:US
Mailing Address - Phone:865-546-9246
Mailing Address - Fax:865-523-6466
Practice Address - Street 1:1932 ALCOA HWY
Practice Address - Street 2:SUITE C460
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920
Practice Address - Country:US
Practice Address - Phone:865-546-9246
Practice Address - Fax:865-523-6466
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036121098207R00000X
TNMD47959207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
3723987Medicare PIN