Provider Demographics
NPI:1649524448
Name:ORTHOKNOX
Entity type:Organization
Organization Name:ORTHOKNOX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:W
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:HOVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-251-3034
Mailing Address - Street 1:10810 PARKSIDE DR
Mailing Address - Street 2:SUITE 209
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-1979
Mailing Address - Country:US
Mailing Address - Phone:865-251-3034
Mailing Address - Fax:865-966-0191
Practice Address - Street 1:10810 PARKSIDE DR
Practice Address - Street 2:SUITE 209
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-1979
Practice Address - Country:US
Practice Address - Phone:865-251-3034
Practice Address - Fax:865-966-0191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-31
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN26191207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty