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Organization

KNOXVILLE PEDIATRIC OPHTHALMOLOGY, PLLC

Active
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Organization

KNOXVILLE PEDIATRIC OPHTHALMOLOGY, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DEBORAH F STOFFLE (OFFICE ADMIN)
(865) 521-7998
Entity
Organization

Contact information

Practice address
2100 W CLINCH AVE, SUITE 400 KOPPEL PLAZA, KNOXVILLE, TN 37916-2219
(865) 521-7998
(865) 521-7405
Mailing address
2100 W CLINCH AVE, SUITE 400 KOPPEL PLAZA, KNOXVILLE, TN 37916-2219
(865) 521-7998
(865) 521-7405

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
14247
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3196142
TN
Enumeration date
09/15/2010
Last updated
08/29/2012
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