Individual
DR. TIMOTHY CHARLES WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1285 DOLLY PARTON PKWY, SEVIERVILLE, TN 37862-3705
(865) 453-3619
(865) 428-5168
Mailing address
1285 DOLLY PARTON PKWY, SEVIERVILLE, TN 37862-3705
(865) 453-3619
(865) 428-5168
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODT1181
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35966431
—
TN
01
—
4148974
BLUE CROSS BLUE SHIELD TN
TN
Enumeration date
07/24/2006
Last updated
01/09/2008
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