Eugene Wayne Dupas Jr.
Individual provider Active NPI Sports Medicine (Physical Medicine & Rehabilitation) Physician · Corryton, TN
NPI 1083172936 · NPPES record last updated Mar 11, 2019
Key facts
- NPI
- 1083172936
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X
- License
- 876 (TN)
- Practice address
- 7628 Tazewell Pike
Corryton, TN 37721-2910 - Phone
- (225) 892-0212
- NPI assigned
- Mar 11, 2019
- 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)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 876 | TN | MD | Marriage & Family Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Physical Medicine & Rehabilitation) Physician | 2081S0010X | 876 | TN | Yes |
Addresses
Primary practice location
7628 Tazewell Pike
Corryton, TN 37721-2910
Mailing address
828 Carter View LN
Knoxville, TN 37924-3442
Phone (225) 892-0212
Other practice location 1
828 Carter View Ln
Knoxville, TN 37924-3442
Phone (225) 892-0212
Other providers in Corryton, TN
- Brett P Carter
- Jason Chen
- Corryton Medical Center P.C.
- Crossroads Pharmacy, LLC
- Jessica Dison
- Jordan L Dyer
- Nicole D Dykes
- Family Medical Care Center, LLC
- Family Practice of Corryton
- Farmer Practice LLC
All providers in Corryton, TN · Sports Medicine (Physical Medicine & Rehabilitation) Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 11, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.