Provider Demographics
NPI:1992795702
Name:DELEESE, JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:DELEESE
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 1:1225 E WEISGARBER RD
Mailing Address - Street 2:SUITE 190
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-2604
Mailing Address - Country:US
Mailing Address - Phone:865-602-6700
Mailing Address - Fax:865-602-6801
Practice Address - Street 1:10810 PARKSIDE DR
Practice Address - Street 2:SUITE 301
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-1979
Practice Address - Country:US
Practice Address - Phone:865-470-2273
Practice Address - Fax:865-693-1163
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN11785207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3829073Medicaid
TN3829073Medicaid
TN3173823Medicare PIN
TN103I060798Medicare PIN
TNB03621Medicare UPIN
110038582Medicare PIN
TN103I066494Medicare PIN