Provider Demographics
NPI:1699798884
Name:TATUM, ROBERT K (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:K
Last Name:TATUM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:10810 PARKSIDE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-1980
Mailing Address - Country:US
Mailing Address - Phone:865-218-6660
Mailing Address - Fax:865-218-6661
Practice Address - Street 1:10810 PARKSIDE DR STE 100
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-1980
Practice Address - Country:US
Practice Address - Phone:865-218-6660
Practice Address - Fax:865-218-6661
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD014732207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3003029Medicaid
TN3003022Medicare PIN
TN3003029Medicaid