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NPI Code Detail

MEDICARE: CAROL SOMMERFELT ELD

MEDICARE:   CAROL  SOMMERFELT  ELD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1247ZC0005XClinical Laboratory Director (Non-physician)

General Provider Information

NPI Number : 1164858924
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROL SOMMERFELT ELD
Provider Business Mailing Address
First Line : 11126 KINGSTON PIKE
Second Line :
City : KNOXVILLE
State : TN
Zip : 37934-2806
Country : US
Telephone Number : 865-777-0088
Fax Number :
Provider Business Practice Location Address
First Line : 11126 KINGSTON PIKE
Second Line :
City : KNOXVILLE
State : TN
Zip : 37934-2806
Country : US
Telephone Number : 865-777-0088
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/24/2013
Last Update Date : 09/24/2013

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Directions to “ CAROL SOMMERFELT ELD” Practice Location

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