Organization
TIMOTHY L. GARDNER,DPM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY LOGAN GARDNER DPM (PRESIDENT)
(865) 218-7474
Entity
Organization
Contact information
Practice address
10810 PARKSIDE DR STE 202, KNOXVILLE, TN 37934-1981
(865) 218-7474
(865) 218-7475
Mailing address
10810 PARKSIDE DR STE 202, KNOXVILLE, TN 37934-1981
(865) 218-7474
(865) 218-7475
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
DPM409
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0191729
BCBS
TN
05
—
3351921
—
TN
Enumeration date
08/27/2007
Last updated
06/18/2008
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