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General NPI Number Information
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NPI Number | 1699787994
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Entity Type | Organization
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Legal Business Name | EAST TENNESSEE FOOT CONSULTANTS
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Dates
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Enumeration Date | 08/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9330 PARK WEST BLVD SUITE 508
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City | KNOXVILLE
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State | TN
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Zip | 37923-4308
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Country | US
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Telephone | 865-691-1115
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Fax | 865-691-8055
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Provider Business Mailing Address
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Address Line | 9330 PARK WEST BLVD SUITE 508
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City | KNOXVILLE
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State | TN
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Zip | 37923-4308
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Country | US
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Telephone | 865-691-1115
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Fax | 865-691-8055
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. RICKY S CAPLAN
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Credential | DPM
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Telephone | 865-691-1115
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | DPM000312
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License Number State | TN
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