Provider Demographics
NPI:1316974678
Name:RAINWATER, DENNIS L (MD)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:L
Last Name:RAINWATER
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 1:1633 W MORRIS BLVD
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37813-3875
Mailing Address - Country:US
Mailing Address - Phone:423-492-6700
Mailing Address - Fax:865-374-2131
Practice Address - Street 1:1633 W MORRIS BLVD
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37813
Practice Address - Country:US
Practice Address - Phone:423-492-6700
Practice Address - Fax:865-374-2131
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0079512207R00000X
TNMD17343207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL258172800Medicaid
TNQ011877Medicaid
FLA98707Medicare UPIN