Provider Demographics
NPI:1982645248
Name:PALATINUS, JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:PALATINUS
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 7086
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37831-3386
Mailing Address - Country:US
Mailing Address - Phone:865-483-7740
Mailing Address - Fax:865-483-0155
Practice Address - Street 1:119 BALBOA CIR
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-7822
Practice Address - Country:US
Practice Address - Phone:865-483-7740
Practice Address - Fax:865-483-0155
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD08824207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0119700OtherBLUE CROSS
TN930005381OtherRAILROAD MEDICARE
TN3173600Medicaid
TN3173600Medicare PIN