Provider Demographics
NPI:1184698854
Name:HYATT, RENEE JOY (MD)
Entity type:Individual
Prefix:DR
First Name:RENEE
Middle Name:JOY
Last Name:HYATT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:339 BMH PHYSICIANS OFFICE BLDG
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37804-5820
Mailing Address - Country:US
Mailing Address - Phone:865-980-5200
Mailing Address - Fax:865-980-5201
Practice Address - Street 1:255 E WATT ST
Practice Address - Street 2:
Practice Address - City:ALCOA
Practice Address - State:TN
Practice Address - Zip Code:37701-2236
Practice Address - Country:US
Practice Address - Phone:865-273-1616
Practice Address - Fax:865-273-1645
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000021324207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN10311I0700OtherPTAN
TN3065007Medicaid
TN3065007Medicare PIN
TN10311I0700OtherPTAN
TN30650041Medicare PIN