Healthcare Provider Details

I. General information

NPI: 1548259906
Provider Name (Legal Business Name): JEFFREY R ALBEA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2005
Last Update Date: 04/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9330 PARK WEST BLVD SUITE 200
KNOXVILLE TN
37923-4308
US

IV. Provider business mailing address

9330 PARK WEST BLVD SUITE 200
KNOXVILLE TN
37923-4308
US

V. Phone/Fax

Practice location:
  • Phone: 865-373-5100
  • Fax: 865-373-9006
Mailing address:
  • Phone: 865-373-5100
  • Fax: 865-373-9006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number200126
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number53148
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: