Organization
EAST TENNESSEE CHILDREN'S HOSPITAL ASSOCIATION INC.
Active
Parent organization
EAST TENNESSEE CHILDREN'S HOSPITAL ASSOCIATION, INC.
Other names
ETCH Pediatric Plastic and Reconstructive Surgery
Organization subpart
Yes
Provider details
NPI number
Legal business name
EAST TENNESSEE CHILDREN'S HOSPITAL ASSOCIATION, INC.
Authorized official
ANDREW ROSENDAHL (CHIEF FINANCIAL OFFICER)
(865) 541-8154
Entity
Organization
Contact information
Practice address
2100 CLINCH AVENUE SUITE 510, KNOXVILLE, TN 37916-2225
(865) 824-4939
(866) 630-2013
Mailing address
PO BOX 15004, KNOXVILLE, TN 37901-5004
(865) 541-8895
(865) 633-4808
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
208200000X
Plastic Surgery Physician
—
—
2086S0120X
Pediatric Surgery Physician
—
—
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q064872
—
TN
Enumeration date
03/30/2021
Last updated
12/30/2025
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