Individual
DR. KEITH EDWARD WHALEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2541 SAND PIKE BLVD, PIGEON FORGE, TN 37863-6205
(865) 428-0959
(865) 429-0923
Mailing address
2541 SAND PIKE BLVD, PIGEON FORGE, TN 37863-6205
(865) 428-0959
(865) 429-0923
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD1729
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3041669
BCBS
TN
05
—
3940567
—
TN
01
—
621651733
CHAMPVA
TN
Enumeration date
07/12/2006
Last updated
05/03/2012
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