Provider Demographics
NPI:1821225327
Name:VISCONTI, KEVIN CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:CHARLES
Last Name:VISCONTI
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 1:1930 ALCOA HWY STE A435
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1520
Mailing Address - Country:US
Mailing Address - Phone:865-263-2400
Mailing Address - Fax:865-263-2441
Practice Address - Street 1:2335 KNOB CREEK RD STE 100
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-2002
Practice Address - Country:US
Practice Address - Phone:423-430-9942
Practice Address - Fax:423-212-8700
Is Sole Proprietor?:No
Enumeration Date:2009-06-11
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN50829207VM0101X
TNMD0000050829207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology