Basic Information
| Provider Information | |||||||||
| NPI: | 1346288727 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TUMKUR | ||||||||
| FirstName: | ANIL | ||||||||
| MiddleName: | V | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 900 E HILL AVE | ||||||||
| Address2: | SUITE 230 | ||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379152566 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8658620998 | ||||||||
| FaxNumber: | 8655441861 | ||||||||
| Practice Location | |||||||||
| Address1: | 1410 TUSCULUM BLVD | ||||||||
| Address2: | SUITE 2200 | ||||||||
| City: | GREENEVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 377454286 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4236390243 | ||||||||
| FaxNumber: | 4236390628 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/04/2006 | ||||||||
| LastUpdateDate: | 07/06/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 35410 | TN | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RH0003X | 35410 | TN | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
ID Information
| ID | Type | State | Issuer | Description | P01421339 | 01 | TN | MEDICARE RR | OTHER | Q011063 | 05 | TN | MEDICAID |