Basic Information
| Provider Information | |||||||||
| NPI: | 1538148630 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BAUMGARTNER | ||||||||
| FirstName: | NORBERT | ||||||||
| MiddleName: | E. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9125 CROSS PARK DR STE 200 | ||||||||
| Address2: | |||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379234563 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8656325900 | ||||||||
| FaxNumber: | 8653742129 | ||||||||
| Practice Location | |||||||||
| Address1: | 9125 CROSS PARK DR STE 200 | ||||||||
| Address2: | |||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379234563 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8656325900 | ||||||||
| FaxNumber: | 8653742129 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/17/2006 | ||||||||
| LastUpdateDate: | 08/16/2019 | ||||||||
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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 | 208G00000X | 4301067811 | MI | N | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 208G00000X | 59694 | TN | Y | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
ID Information
| ID | Type | State | Issuer | Description | 4526737 | 05 | MI | MEDICAID | Q050926 | 05 | TN | MEDICAID |