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General NPI Number Information
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NPI Number | 1891984712
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Entity Type | Organization
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Legal Business Name | GREAT EXPECTATIONS OB/GYN/AESTHETICS, PLLC
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Dates
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Enumeration Date | 10/16/2007
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Last Update Date | 10/16/2007
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Provider Practice Location Address
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Address Line | 2001 HIGHLAND AVE
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City | KNOXVILLE
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State | TN
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Zip | 37916-1217
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Country | US
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Telephone | 865-971-6877
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Fax | 865-971-6817
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Provider Business Mailing Address
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Address Line | 2001 HIGHLAND AVE
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City | KNOXVILLE
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State | TN
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Zip | 37916-1217
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Country | US
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Telephone | 865-971-6877
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Fax | 865-971-6817
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Authorized Official
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Title or Position | OWNER
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Name | HOLL E NOONAN
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Credential | M.D.
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Telephone | 865-971-6877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 34863
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License Number State | TN
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