Healthcare Provider Details

I. General information

NPI: 1275586224
Provider Name (Legal Business Name): ALLERGY SPECIALISTS OF KNOXVILLE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 12/11/2023
Certification Date: 12/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1346 DOWELL SPRINGS BLVD
KNOXVILLE TN
37909-2453
US

IV. Provider business mailing address

1346 DOWELL SPRINGS BLVD
KNOXVILLE TN
37909-2453
US

V. Phone/Fax

Practice location:
  • Phone: 865-588-2753
  • Fax: 865-588-7418
Mailing address:
  • Phone: 865-588-2753
  • Fax: 865-588-7418

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State

VIII. Authorized Official

Name: KIM DANIEL
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 865-588-2753