Individual
MR. MARK DAVID KIRSHNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.PED, CO
Contact information
Practice address
8823 PRODUCTION LN, OOLTEWAH, TN 37363-6511
(423) 238-7217
(423) 285-6647
Mailing address
104 JACK DANCE ST, KNOXVILLE, TN 37919-5576
(865) 691-8381
(865) 691-8574
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7703026
—
NC
Enumeration date
10/12/2006
Last updated
10/13/2014
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