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Organization

BOULEVARD ENT SURGERY CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JANELLE L JOHNSON RN, BSN (ADMINISTRATIVE DIRECTOR)
(865) 427-4040
Entity
Organization

Contact information

Practice address
9300 PARK WEST BLVD, KNOXVILLE, TN 37923-4301
(865) 427-4040
(865) 427-4041
Mailing address
9300 PARK WEST BLVD, KNOXVILLE, TN 37923-4301
(865) 427-4040
(865) 427-4041

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary

Other

Enumeration date
03/30/2023
Last updated
03/30/2023
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