Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0003X | Hematology & Oncology | MD0000019955 | TN |
Y | 207RX0202X | Medical Oncology | MD0000019955 | TN |
NPI | 1104826148 |
---|---|
Provider Name | Tracy William Dobbs |
First Address | Knoxville, TN 37915-2565 |
Second Address | Knoxville, TN 37909-1341 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2005 |
Last Update Date | 12/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E35906 | (02) |