Provider Demographics
NPI:1417769779
Name:KNOX PRIMARY CARE LLC
Entity type:Organization
Organization Name:KNOX PRIMARY CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:AMISH
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-406-0677
Mailing Address - Street 1:12278 FREDERICKSBURG BLVD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-6667
Mailing Address - Country:US
Mailing Address - Phone:865-406-0677
Mailing Address - Fax:865-347-3975
Practice Address - Street 1:9314 PARK WEST BLVD STE 404
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4329
Practice Address - Country:US
Practice Address - Phone:865-234-2347
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-23
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty