Healthcare Provider Details

I. General information

NPI: 1932566734
Provider Name (Legal Business Name): ALLERGY ASSOCIATES, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2016
Last Update Date: 01/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2070 WILLOW LOOP WAY
KNOXVILLE TN
37922-2015
US

IV. Provider business mailing address

6701 BAUM DR SUITE 140
KNOXVILLE TN
37919-7360
US

V. Phone/Fax

Practice location:
  • Phone: 865-200-4849
  • Fax: 865-200-9858
Mailing address:
  • Phone: 865-584-5727
  • Fax: 865-450-9904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number4738
License Number StateTN

VIII. Authorized Official

Name: ROBERT M OVERHOLT
Title or Position: OWNER
Credential: MD
Phone: 865-584-5727