Healthcare Provider Details

I. General information

NPI: 1952484354
Provider Name (Legal Business Name): EAST TENNESSEE EYE SURGEONS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 03/22/2021
Certification Date: 03/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7800 CONNER RD
POWELL TN
37849-3511
US

IV. Provider business mailing address

7800 CONNER RD
POWELL TN
37849-3511
US

V. Phone/Fax

Practice location:
  • Phone: 865-546-1464
  • Fax: 865-546-0470
Mailing address:
  • Phone: 865-546-1464
  • Fax: 865-546-0470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberMD007146
License Number StateTN

VIII. Authorized Official

Name: DR. JOHN TURNER DAWSON
Title or Position: DIRECTOR/OFFICER
Credential: M.D.
Phone: 865-546-1464