Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | MD20355 | TN |
NPI | 1023018728 |
---|---|
Provider Name | Ross Eric Kerns |
First Address | Knoxville, TN 37915-2565 |
Second Address | Knoxville, TN 37932-3366 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2005 |
Last Update Date | 09/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C66100 | (02) |