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NPI Code Detail

MEDICARE: ALLERGY & ASTHMA AFFILIATES, PC

MEDICARE: ALLERGY & ASTHMA AFFILIATES, 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
1207K00000XAllergy & Immunology Physician

General Provider Information

NPI Number : 1780809012
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALLERGY & ASTHMA AFFILIATES, PC
Provider Business Mailing Address
First Line : 2121 HIGHLAND AVE
Second Line :
City : KNOXVILLE
State : TN
Zip : 37916-1111
Country : US
Telephone Number : 865-525-2640
Fax Number : 865-252-9536
Provider Business Practice Location Address
First Line : 2121 HIGHLAND AVE
Second Line :
City : KNOXVILLE
State : TN
Zip : 37916-1111
Country : US
Telephone Number : 865-525-2640
Fax Number : 865-252-9536
Authorized Official
Title or Position : PRACTICE MANAGER
Name : LOUIS MAVROFF
Credential :
Telephone Number : 865-525-2640
Provider Enumeration Date : 04/13/2007
Last Update Date : 03/28/2008

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