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General NPI Number Information
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NPI Number | 1023338688
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Entity Type | Individual
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Provider Name | LAURA M ENOMOTO MD
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Gender | Female
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Dates
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Enumeration Date | 06/07/2010
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Last Update Date | 04/19/2021
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Provider Practice Location Address
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Address Line | 1926 ALCOA HWY STE 300
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City | KNOXVILLE
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State | TN
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Zip | 37920-1555
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Country | US
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Telephone | 865-544-9218
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Fax | 865-305-8262
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Provider Business Mailing Address
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Address Line | PO BOX 415000-MSC8159
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City | NASHVILLE
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State | TN
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Zip | 37241-8159
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Country | US
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Telephone | 865-670-6199
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Fax | 865-670-6198
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MT197293
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2086X0206X
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Taxonomy Name | Surgical Oncology Physician
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License Number | 59953
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License Number State | TN
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