Healthcare Provider Details

I. General information

NPI: 1205132305
Provider Name (Legal Business Name): DR. ALAN SCHWARTZ
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2011
Last Update Date: 02/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10900 PARKSIDE DR
KNOXVILLE TN
37934-1958
US

IV. Provider business mailing address

10900 PARKSIDE DR
KNOXVILLE TN
37934-1958
US

V. Phone/Fax

Practice location:
  • Phone: 865-777-5155
  • Fax: 866-514-9625
Mailing address:
  • Phone: 865-777-5155
  • Fax: 866-514-9625

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License NumberOD407
License Number StateTN

VIII. Authorized Official

Name: DR. MICHAEL ALAN SCHWARTZ
Title or Position: OPTOMETRIST
Credential: O.D.
Phone: 865-777-5155