Healthcare Provider Details

I. General information

NPI: 1760656797
Provider Name (Legal Business Name): ALLERGY ASSOCIATES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2008
Last Update Date: 02/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1317 CUMBERLAND FALLS HWY SUITE A
CORBIN KY
40701-2720
US

IV. Provider business mailing address

6701 BAUM DR SUITE 140
KNOXVILLE TN
37919-7360
US

V. Phone/Fax

Practice location:
  • Phone: 865-584-8588
  • Fax: 865-584-3364
Mailing address:
  • Phone: 865-584-5727
  • Fax: 865-450-9904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number26755
License Number StateKY

VIII. Authorized Official

Name: MR. ROBERT M OVERHOLT
Title or Position: PRESIDENT/OWNER
Credential: M.D.
Phone: 865-584-8588