| Tennessee River Medical Group Pc | |
|
6311 Kingston Pike Ste 26w Knoxville TN 37919-4900 | |
| (865) 674-9193 | |
| Not Available |
| Full Name | Tennessee River Medical Group Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6311 Kingston Pike Ste 26w, Knoxville, Tennessee |
| Authorized Official Name and Position | Jimmy D Gentry (PRESIDENT) |
| Authorized Official Contact | 8656749193 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tennessee River Medical Group Pc 6311 Kingston Pike Ste 26w Knoxville TN 37919-4900 Ph: (865) 674-9193 | Tennessee River Medical Group Pc 6311 Kingston Pike Ste 26w Knoxville TN 37919-4900 Ph: (865) 674-9193 |
| NPI Number | 1316792492 |
|---|---|
| Provider Enumeration Date | 04/22/2024 |
| Last Update Date | 11/26/2024 |
| Medicare PECOS PAC ID | 3678002805 |
|---|---|
| Medicare Enrollment ID | O20250131003540 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316792492 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207RN0300X | Internal Medicine - Nephrology | (* (Not Available)) | Primary |
| Provider Name | Jimmy D Gentry |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1467896365 PECOS PAC ID: 7719291582 Enrollment ID: I20201204002583 |
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