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General NPI Number Information
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NPI Number | 1629195797
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Entity Type | Organization
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Legal Business Name | KNOXVILLE EYE CENTER LLC
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 05/07/2018
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Provider Practice Location Address
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Address Line | 200 FORT SANDERS WEST BLVD STE 101
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City | KNOXVILLE
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State | TN
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Zip | 37922-3357
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Country | US
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Telephone | 865-694-2021
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Fax | 865-694-8234
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Provider Business Mailing Address
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Address Line | 200 FORT SANDERS WEST BLVD STE 101
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City | KNOXVILLE
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State | TN
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Zip | 37922-3358
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Country | US
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Telephone | 865-694-2021
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Fax | 865-694-8234
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Authorized Official
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Title or Position | OWNER
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Name | ROBERT E PRICE
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Credential | MD
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Telephone | 865-694-2021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MD022058
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License Number State | TN
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