Healthcare Provider Details

I. General information

NPI: 1467552216
Provider Name (Legal Business Name): EAST TENNESSEE EAR, NOSE & THROAT SPECIALISTS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 01/19/2026
Certification Date: 01/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 OAK RIDGE TURNPIKE SUITE C-100
OAK RIDGE TN
37830
US

IV. Provider business mailing address

800 OAK RIDGE TPKE STE C100
OAK RIDGE TN
37830-6927
US

V. Phone/Fax

Practice location:
  • Phone: 865-483-2288
  • Fax: 865-482-4400
Mailing address:
  • Phone: 865-483-2288
  • Fax: 865-482-4400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2355A2700X
TaxonomyAudiology Assistant
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: HOLLY MICHELLE SMITH
Title or Position: PRACTICE MANAGER
Credential:
Phone: 865-483-2288