Provider Demographics
NPI:1992828321
Name:GAIL E. GNADE,PH.D
Entity Type:Organization
Organization Name:GAIL E. GNADE,PH.D
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:GNADE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:865-909-1490
Mailing Address - Street 1:679 EMORY VALLEY RD.
Mailing Address - Street 2:SUITE B
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830
Mailing Address - Country:US
Mailing Address - Phone:865-909-1490
Mailing Address - Fax:865-220-0782
Practice Address - Street 1:679 EMORY VALLEY RD.
Practice Address - Street 2:SUITE B
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830
Practice Address - Country:US
Practice Address - Phone:865-909-1490
Practice Address - Fax:865-220-0728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP1676171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3686935Medicare ID - Type Unspecified