Organization
DRS BLACK&BENTON PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DONNA KESTERSON OM (INSURANCE)
(865) 687-1940
Entity
Organization
Contact information
Practice address
4741 N BROADWAY ST STE B, KNOXVILLE, TN 37918-1793
(865) 687-1940
(865) 687-0157
Mailing address
4741 N BROADWAY ST STE B, KNOXVILLE, TN 37918-1793
(865) 687-1940
(865) 687-0157
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
MD17837
TN
Other
Enumeration date
09/03/2014
Last updated
09/03/2014
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