Provider Demographics
NPI:1063547453
Name:SENTER, RILEY S (MD)
Entity type:Individual
Prefix:
First Name:RILEY
Middle Name:S
Last Name:SENTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7035 MIDDLEBROOK PKE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-1903
Mailing Address - Country:US
Mailing Address - Phone:865-934-2655
Mailing Address - Fax:865-622-9138
Practice Address - Street 1:7035 MIDDLEBROOK PKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-1903
Practice Address - Country:US
Practice Address - Phone:865-934-2655
Practice Address - Fax:865-622-9138
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD000009519207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3806872Medicaid
TN3806872Medicaid
TN3806872Medicare ID - Type Unspecified