Basic Information
Provider Information
NPI: 1639179229
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FENG
FirstName: YI
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
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Mailing Information
Address1: 900 E HILL AVE STE 230
Address2:  
City: KNOXVILLE
State: TN
PostalCode: 379152565
CountryCode: US
TelephoneNumber: 8658620998
FaxNumber: 8655441861
Practice Location
Address1: 7650 DANNAHER DR STE 100
Address2:  
City: POWELL
State: TN
PostalCode: 378494066
CountryCode: US
TelephoneNumber: 8656379330
FaxNumber: 8655126748
Other Information
ProviderEnumerationDate: 07/26/2005
LastUpdateDate: 04/09/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/09/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RH0003X36528KYN Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
207RH0003XMD0000038385TNY Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology

No ID Information.


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