Provider Demographics
NPI:1801861786
Name:WARREN, CALEB (MD)
Entity Type:Individual
Prefix:
First Name:CALEB
Middle Name:
Last Name:WARREN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3403 TAZEWELL PIKE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37918-2620
Mailing Address - Country:US
Mailing Address - Phone:865-689-9966
Mailing Address - Fax:865-689-0910
Practice Address - Street 1:3403 TAZEWELL PIKE
Practice Address - Street 2:SUITE 102
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37918-2620
Practice Address - Country:US
Practice Address - Phone:865-689-9966
Practice Address - Fax:865-689-0910
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD028800207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4317845OtherBCBS
TN080129118OtherRAILROAD MEDICARE
TN01-41213OtherUNITED HEALTHCARE PROVIDE
TN3104837OtherBLUE CROSS BLUE SHIELD TN
TN3827019Medicaid
TN5374697OtherAETNA PROVIDER NUMBER
TN62175607102OtherJOHN DEERE HEALTH PROVIDE
TN4317845OtherBCBS
TN3827018Medicare ID - Type Unspecified
TN3104837OtherBLUE CROSS BLUE SHIELD TN