Enderson, Blaine L.

Enderson, Blaine L. is an individual health care provider with primary practice located at 1924 Alcoa Hwy U114, Knoxville TN 37920-1511. He recently has only one registered license in Allopathic & Osteopathic Physicians / Trauma Surgery, which is considered as his primary health care specialty. Enderson, Blaine L. can be contacted via phone (865) 305-9340.

Contact Information

Primary practice address
1924 Alcoa Hwy U114 Knoxville TN 37920-1511
Phone: (865) 305-9340
Fax: (865) 305-9231
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Trauma Surgery 2086S0127X MD0000018190 Tennessee

Profile Details

NPI number 1346283553
LBN Legal business name Enderson, Blaine L.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2006
Last updated Sep 27th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346283553 NPPES
Tennessee MEDICAID 3028291
Tennessee MEDICAID 3028290

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