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General NPI Number Information
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NPI Number | 1467987339
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Entity Type | Individual
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Provider Name | CLAYTON KOLLE M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/27/2017
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Last Update Date | 11/02/2024
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Provider Practice Location Address
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Address Line | 1924 ALCOA HWY
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City | KNOXVILLE
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State | TN
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Zip | 37920-1511
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Country | US
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Telephone | 865-305-9200
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Fax |
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Provider Business Mailing Address
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Address Line | 2705 BRANTLEY PARK BLVD
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City | MARYVILLE
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State | TN
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Zip | 37804-3189
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Country | US
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Telephone | 817-913-5335
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Fax | 619-532-5507
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 66537
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License Number State | TN
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