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NPI Code Detail

MEDICARE: SOUTHEASTERN DERMATOLOGY CONSULTANTS, PC

MEDICARE: SOUTHEASTERN DERMATOLOGY CONSULTANTS, PC
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
1207N00000XDermatology PhysicianDO1589TN

General Provider Information

NPI Number : 1427109446
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTHEASTERN DERMATOLOGY CONSULTANTS, PC
Provider Business Mailing Address
First Line : 1930 PINNACLE POINTE WAY
Second Line :
City : KNOXVILLE
State : TN
Zip : 37922-6702
Country : US
Telephone Number : 865-474-8800
Fax Number : 865-474-8806
Provider Business Practice Location Address
First Line : 1930 PINNACLE POINTE WAY
Second Line :
City : KNOXVILLE
State : TN
Zip : 37922-6702
Country : US
Telephone Number : 865-474-8800
Fax Number : 865-474-8806
Authorized Official
Title or Position : OWNER
Name : DR. MATTHEW BRENT DOPPELT
Credential : D.O.
Telephone Number : 865-632-5975
Provider Enumeration Date : 01/16/2007
Last Update Date : 06/25/2026

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Directions to “SOUTHEASTERN DERMATOLOGY CONSULTANTS, PC ” Practice Location

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