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Organization

KENNETH R LISTER, MD, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
HEATHER ELEAZER (PRACTICE MANAGER)
(865) 694-6919
Entity
Organization

Contact information

Practice address
116 BROWN AVE, CROSSVILLE, TN 38555-7703
(865) 694-6919
(865) 694-4339
Mailing address
PO BOX 52364, KNOXVILLE, TN 37950-2364
(865) 694-6919
(865) 694-4339

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
TN

Other

Enumeration date
08/17/2006
Last updated
08/22/2020
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