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General NPI Number Information
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NPI Number | 1023578267
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Entity Type | Individual
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Provider Name | REBECCA JOHNSON AGNER DO
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Gender | Female
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Dates
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Enumeration Date | 03/22/2019
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 224 S PETERS ROAD SUITE 105
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City | KNOXVILLE
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State | TN
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Zip | 37923
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Country | US
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Telephone | 865-470-8844
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Fax | 866-479-4403
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Provider Business Mailing Address
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Address Line | PO BOX 15004
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City | KNOXVILLE
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State | TN
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Zip | 37901-5004
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Country | US
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Telephone | 865-541-8895
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Fax | 865-633-4808
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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 | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | 5654
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 5654
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License Number State | TN
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