Individual
WILLIAM R PEDERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
730 W LAMAR ALEXANDER PKWY, MARYVILLE, TN 37801-3900
(865) 982-2020
(865) 970-2020
Mailing address
730 W LAMAR ALEXANDER PKWY, MARYVILLE, TN 37801-3900
(865) 982-2020
(865) 970-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD0000000552
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2005369
BLUE CROSS BLUE SHIELD
TN
01
—
602004601
CARITEN
—
01
—
620927830
UNITED HEALTHCARE
—
Enumeration date
07/20/2005
Last updated
09/15/2014
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