Provider Demographics
NPI:1932193471
Name:RIVERS, DENISE MARIE (DO)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:MARIE
Last Name:RIVERS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:MARIE
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:1932 ALCOA HWY
Mailing Address - Street 2:C-460
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1527
Mailing Address - Country:US
Mailing Address - Phone:865-546-9246
Mailing Address - Fax:865-523-6466
Practice Address - Street 1:1932 ALCOA HWY
Practice Address - Street 2:C-460
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1527
Practice Address - Country:US
Practice Address - Phone:865-546-9246
Practice Address - Fax:865-523-6466
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDO1365207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3723987Medicaid
TN3155223OtherBCBS
TN390007390OtherRAILROAD MEDICARE
TN3723987Medicaid
TN3155223OtherBCBS