Basic Information
| Provider Information | |||||||||
| NPI: | 1013913839 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZIRKLE | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | WM | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1225 E WEISGARBER RD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379092604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8655844747 | ||||||||
| FaxNumber: | 8655841363 | ||||||||
| Practice Location | |||||||||
| Address1: | 120 HOSPITAL DR | ||||||||
| Address2: | STE 130 | ||||||||
| City: | JEFFERSON CTY | ||||||||
| State: | TN | ||||||||
| PostalCode: | 377605279 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8654754742 | ||||||||
| FaxNumber: | 8652620100 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2005 | ||||||||
| LastUpdateDate: | 08/06/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD0000007203 | TN | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 3706633 | 01 | TN | MEDICARE LEGACY GROUP | OTHER |