Organization
SOUTHEASTERN RETINA ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW LAVERGHETTA (CEO)
(865) 474-7596
Entity
Organization
Contact information
Practice address
1961 NORTHPOINT BLVD STE 110, HIXSON, TN 37343-4556
(423) 756-1002
Mailing address
9050 EXECUTIVE PARK DR STE 202A, KNOXVILLE, TN 37923-4670
(865) 588-0811
(865) 934-3892
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
—
—
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3715425
—
TN
Enumeration date
03/14/2008
Last updated
11/04/2025
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