Healthcare Provider Details

I. General information

NPI: 1720365893
Provider Name (Legal Business Name): MR. RONALD LLEWELLYN FLOWERS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: RONALD LLEWELLYN FLOWERS PA

II. Dates (important events)

Enumeration Date: 11/03/2011
Last Update Date: 11/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9135 MIDDLEBROOK PIKE
KNOXVILLE TN
37923-1425
US

IV. Provider business mailing address

882 PROFFITT SPRINGS RD
MARYVILLE TN
37801-1711
US

V. Phone/Fax

Practice location:
  • Phone: 865-558-3038
  • Fax:
Mailing address:
  • Phone: 865-898-1570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number139
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: