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General NPI Number Information
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NPI Number | 1659648871
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Entity Type | Organization
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Legal Business Name | SLEEP APNEA PROFESSIONALS LLC
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Dates
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Enumeration Date | 11/17/2011
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Last Update Date | 01/12/2012
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Provider Practice Location Address
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Address Line | 6311 KINGSTON PIKE SUITE 8-W
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City | KNOXVILLE
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State | TN
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Zip | 37919-4906
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Country | US
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Telephone | 865-306-5995
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Fax | 877-568-5379
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Provider Business Mailing Address
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Address Line | PO BOX 91627
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City | MOBILE
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State | AL
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Zip | 36691-1627
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Country | US
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Telephone | 865-306-5995
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Fax | 877-568-5379
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FREDRICO ALBERT DIXON III
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Credential | DDS
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Telephone | 865-306-5995
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 7270
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License Number State | TN
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