MEDICARE: ALLERGY SPECIALISTS OF KNOXVILLE PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207K00000X	Allergy & Immunology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275586224
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLERGY SPECIALISTS OF KNOXVILLE PLLC

Provider Business Mailing Address
First Line	:	1346 DOWELL SPRINGS BLVD
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37909-2453
Country	:	US
Telephone Number	:	865-588-2753
Fax Number	:	865-588-7418

Provider Business Practice Location Address
First Line	:	1346 DOWELL SPRINGS BLVD
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37909-2453
Country	:	US
Telephone Number	:	865-588-2753
Fax Number	:	865-588-7418

Authorized Official
Title or Position	:	PRACTICE ADMINISTRATOR
Name	:	KIM DANIEL
Credential	:
Telephone Number	:	865-588-2753

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	12/11/2023

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