Provider Demographics
NPI:1679573372
Name:SCHROCK, NATHAN ERIC (MD)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:ERIC
Last Name:SCHROCK
Suffix:
Gender:M
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:PO BOX 10988
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37939-0988
Mailing Address - Country:US
Mailing Address - Phone:865-862-0998
Mailing Address - Fax:865-544-1861
Practice Address - Street 1:101 BLOUNT AVE
Practice Address - Street 2:STE 610
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920
Practice Address - Country:US
Practice Address - Phone:865-632-5122
Practice Address - Fax:865-632-5116
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000037305207RH0003X
KY37971207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3884972Medicaid
KY64071244OtherMEDICAID
TN3884972Medicare PIN
H92020Medicare UPIN
TN3884972Medicaid
KY647907Medicare PIN