Provider Demographics
NPI:1528421658
Name:SHIFLETT, HENRY (DO)
Entity type:Individual
Prefix:DR
First Name:HENRY
Middle Name:
Last Name:SHIFLETT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 19TH STREET
Mailing Address - Street 2:TRUSTEES TOWER, SUITE 600
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37916
Mailing Address - Country:US
Mailing Address - Phone:865-331-9160
Mailing Address - Fax:865-374-2203
Practice Address - Street 1:501 19TH STREET
Practice Address - Street 2:TRUSTEES TOWER, SUITE 600
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37916
Practice Address - Country:US
Practice Address - Phone:865-331-9160
Practice Address - Fax:865-374-2203
Is Sole Proprietor?:No
Enumeration Date:2016-04-05
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC82081207RI0200X
390200000X
TN4355207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ042903Medicaid