Basic Information
| Provider Information | |||||||||
| NPI: | 1982764593 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KANABAR | ||||||||
| FirstName: | HASMUKH | ||||||||
| MiddleName: | VANMALI | ||||||||
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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: | 167 WARREN ST | ||||||||
| Address2: | |||||||||
| City: | MADISONVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 373543001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4234425480 | ||||||||
| FaxNumber: | 4234424416 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/12/2006 | ||||||||
| LastUpdateDate: | 04/08/2013 | ||||||||
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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 | 207Q00000X | MD0000026806 | TN | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 080144900 | 01 | RAILROAD MEDICARE | OTHER | 3066220 | 01 | TN | BLUECROSS BLUESHIELD | OTHER | 3092494 | 05 | TN | MEDICAID | 4867910007 | 01 | CIGNA INSURANCE | OTHER |