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Individual

DOUGLAS H LUTTRELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
930 E EMERALD AVE, STE 813, KNOXVILLE, TN 37917-4539
(865) 546-9751
Mailing address
1225 E WEISGARBER RD, SUITE 200, KNOXVILLE, TN 37909-2604
(865) 584-4747

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN92050
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3345173
TN
01
500028566
RR MEDICARE PIN
TN
Enumeration date
06/28/2006
Last updated
05/08/2008
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