Provider Demographics
NPI:1710915848
Name:AUSTIN, JOSEPH W JR (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:W
Last Name:AUSTIN
Suffix:JR
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 1:1225 E WEISGARBER RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-2604
Mailing Address - Country:US
Mailing Address - Phone:865-584-4747
Mailing Address - Fax:
Practice Address - Street 1:1404 TUSCULUM BLVD
Practice Address - Street 2:LAUGHLIN MOB, SUITE 3100
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745-4395
Practice Address - Country:US
Practice Address - Phone:423-638-4114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN09988207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3177635Medicaid
TN110190585OtherRR MEDICARE
TN3717542Medicare ID - Type UnspecifiedLEGACY GROUP
TN3177639Medicare ID - Type UnspecifiedLEGACY PIN
D32109Medicare UPIN