Monroe A Broome, M.D.

Individual provider Active NPI Diagnostic Radiology Physician · Knoxville, TN

NPI 1013076272 · NPPES record last updated Oct 21, 2022

Key facts

NPI
1013076272
Entity type
Individual (NPI type 1)
Primary specialty
Diagnostic Radiology Physician 2085R0202X
License
15641 (TN)
Practice address
1112 E Weisgarber Rd Ste 102
Knoxville, TN 37909-2647
Phone
(865) 558-9862
Fax
(865) 584-3478
NPI assigned
Dec 6, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
15641TNMDSpecialist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 15641 TN
Diagnostic Radiology Physician 2085R0202X 15641 TN Yes

Addresses

Primary practice location

1112 E Weisgarber Rd Ste 102
Knoxville, TN 37909-2647

Mailing address

1112 E Weisgarber Rd Ste 102
Knoxville, TN 37909-2647
Phone (865) 558-9862

Other identifiers

IdentifierTypeStateIssuer
3012222MedicaidTN

Other providers in Knoxville, TN

All providers in Knoxville, TN · Diagnostic Radiology Physician in Tennessee

Sources for this page

Verify at the official NPI Registry.