Provider Demographics
NPI:1487694212
Name:HOSENFELD, CARL CHRISTOPHER (DC)
Entity type:Individual
Prefix:
First Name:CARL
Middle Name:CHRISTOPHER
Last Name:HOSENFELD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:CHRISTOPHER
Other - Middle Name:CARL
Other - Last Name:HOSENFELD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:4307 BALL CAMP PIKE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37921-3313
Mailing Address - Country:US
Mailing Address - Phone:865-524-1234
Mailing Address - Fax:865-524-2169
Practice Address - Street 1:4307 BALL CAMP PIKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37921-3313
Practice Address - Country:US
Practice Address - Phone:865-524-1234
Practice Address - Fax:865-524-2169
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC0551111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN000118880OtherBLUE CROSS BLUE SHIELD
TN000118880OtherBLUE CROSS BLUE SHIELD
TN621395243OtherEMPLOYER TIN
TN3674579Medicare ID - Type Unspecified