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General NPI Number Information
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NPI Number | 1558467951
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Entity Type | Organization
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Legal Business Name | DERMATOLOGY ASSOCIATES OF OAK RIDGE,PC
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 05/09/2024
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Provider Practice Location Address
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Address Line | 599 OAK RIDGE TPKE
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City | OAK RIDGE
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State | TN
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Zip | 37830-7177
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Country | US
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Telephone | 865-482-2129
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Fax | 865-482-4036
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Provider Business Mailing Address
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Address Line | 599 OAK RIDGE TPKE
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City | OAK RIDGE
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State | TN
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Zip | 37830-7177
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Country | US
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Telephone | 865-482-2129
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Fax | 865-482-4036
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Authorized Official
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Title or Position | PRESIDENT/DERMATOLOGIST
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Name | LELAND C SMITH
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Credential |
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Telephone | 865-482-2129
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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