Provider Demographics
NPI:1639362353
Name:PERSONAL CHOICE HEALTH CARE SERVICE PC
Entity Type:Organization
Organization Name:PERSONAL CHOICE HEALTH CARE SERVICE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:RADER
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:865-692-1400
Mailing Address - Street 1:7210 OAK RIDGE HWY
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37931-2613
Mailing Address - Country:US
Mailing Address - Phone:865-692-1400
Mailing Address - Fax:
Practice Address - Street 1:7210 OAK RIDGE HWY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37931-2613
Practice Address - Country:US
Practice Address - Phone:865-692-1400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-27
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty