Healthcare Provider Details

I. General information

NPI: 1134360910
Provider Name (Legal Business Name): ALLERGY ASSOCIATES, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2009
Last Update Date: 03/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 N WEISGARBER RD SUITE 200
KNOXVILLE TN
37909-2706
US

IV. Provider business mailing address

801 N WEISGARBER RD SUITE 200
KNOXVILLE TN
37909-2706
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD4738
License Number StateTN

VIII. Authorized Official

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