Individual
SAMUEL MARK OVERHOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9430 PARK WEST BLVD, KNOXVILLE, TN 37923-4200
(865) 693-6065
(865) 531-6325
Mailing address
PO BOX 31547, KNOXVILLE, TN 37930-1547
(865) 693-6065
(865) 531-6325
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
28826
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3808346
—
TN
Enumeration date
06/16/2005
Last updated
11/05/2007
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