Healthcare Provider Details

I. General information

NPI: 1164938304
Provider Name (Legal Business Name): DR. ROBERT MATTHEW ALLMON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/26/2017
Last Update Date: 12/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2419 WASHINGTON PIKE
KNOXVILLE TN
37917-3321
US

IV. Provider business mailing address

2419 WASHINGTON PIKE
KNOXVILLE TN
37917-3321
US

V. Phone/Fax

Practice location:
  • Phone: 865-524-3453
  • Fax: 865-524-3453
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0000041454
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: