Provider Demographics
NPI:1659595270
Name:VANTERPOOL, STEPHANIE G (MD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:G
Last Name:VANTERPOOL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1924 ALCOA HWY
Mailing Address - Street 2:BOX U-109
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1511
Mailing Address - Country:US
Mailing Address - Phone:865-588-0880
Mailing Address - Fax:865-584-3111
Practice Address - Street 1:1924 ALCOA HWY
Practice Address - Street 2:BOX U-109
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1511
Practice Address - Country:US
Practice Address - Phone:865-588-0880
Practice Address - Fax:865-584-3111
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2015-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000054383207LP2900X
PAMD439138207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine