Provider Demographics
NPI:1649473455
Name:KNOXVILLE HEMATOLOGY ONCOLOGY ASSOCIATES
Entity type:Organization
Organization Name:KNOXVILLE HEMATOLOGY ONCOLOGY ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:Y
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-588-1847
Mailing Address - Street 1:PO BOX 59076
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37950-9076
Mailing Address - Country:US
Mailing Address - Phone:865-588-1847
Mailing Address - Fax:865-588-7390
Practice Address - Street 1:1451 DOWELL SPRINGS BLVD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-2450
Practice Address - Country:US
Practice Address - Phone:865-588-1847
Practice Address - Fax:568-588-7390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3708778Medicaid
TN3708779Medicaid
TN3708779Medicare ID - Type UnspecifiedHESAMM E. GHARAVI, M.D.
TNB04269Medicare UPIN
TN3708779Medicaid
TNR02408Medicare UPIN
TN3708778Medicare ID - Type UnspecifiedPETER W. CARTER, M.D.
TN3708770Medicare ID - Type UnspecifiedSWEETWATER OFFICE
TNA97412Medicare UPIN
TN3708779Medicare ID - Type UnspecifiedSEVIERVILLE OFFICE
TN3708778Medicare ID - Type UnspecifiedALBERT CS EBENEZER, M.D.
TN3708771Medicare ID - Type UnspecifiedJEFFERSON CITY OFFICE
TNI22790Medicare UPIN
TN3708778Medicare ID - Type UnspecifiedJERRY M. FOSTER, M.D.
TN3708778Medicare ID - Type UnspecifiedALLAN M. GROSSMAN, M.D.