Provider Demographics
NPI:1851592257
Name:ZENG, RONG (MD)
Entity Type:Individual
Prefix:
First Name:RONG
Middle Name:
Last Name:ZENG
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 1:5401 KINGSTON PIKE
Mailing Address - Street 2:STE 540
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-5022
Mailing Address - Country:US
Mailing Address - Phone:865-584-7376
Mailing Address - Fax:865-584-8938
Practice Address - Street 1:1924 ALCOA HWY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1511
Practice Address - Country:US
Practice Address - Phone:865-305-9661
Practice Address - Fax:865-305-6148
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL82392085R0202X
TN439442085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1506539Medicaid
TX185771601Medicaid
TX185771602OtherCIDC
KY7100054680Medicaid
TN3001930Medicare PIN
TX185771601Medicaid