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General NPI Number Information
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NPI Number | 1457859415
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Entity Type | Individual
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Provider Name | LAURA MOBLEY CLIFTON PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/24/2018
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Last Update Date | 08/28/2023
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Provider Practice Location Address
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Address Line | 2202 MARTIN LUTHER KING JR AVE
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City | KNOXVILLE
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State | TN
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Zip | 37915-1570
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Country | US
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Telephone | 865-522-6097
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Fax | 865-540-1615
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Provider Business Mailing Address
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Address Line | 1923 SULPHUR SPRINGS RD
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City | MORRISTOWN
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State | TN
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Zip | 37813-5654
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Country | US
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Telephone | 423-317-9344
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Fax | 423-714-2355
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-07899
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 4225
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License Number State | TN
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