# LOUDON COUNTY PEDIATRICS, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578881132
- **Authorized official:** DWIGHT DANIEL BIVENS (SECRETARY/TREASURER)
- **Authorized official phone:** (865) 986-9233

## Contact information

- **Practice address:** 423 MEDICAL PARK DR, LENOIR CITY, TN 37772-5640
- **Practice address phone:** (865) 986-9233
- **Practice address fax:** (865) 986-0148
- **Mailing address:** 423 MEDICAL PARK DR, LENOIR CITY, TN 37772-5640
- **Mailing address phone:** (865) 986-9233
- **Mailing address fax:** (865) 986-0148

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 364SP0200X | Pediatric Clinical Nurse Specialist | 145961 | TN | Yes |

## Other

- **Enumeration date:** 05/06/2010
- **Last updated:** 05/06/2010