Organization
EAST TENNESSEE PLASTIC SURGERY,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY LYNN WILSON (OFFICE MANAGER)
(865) 694-9886
Entity
Organization
Contact information
Practice address
9430 PARK WEST BLVD STE 240, KNOXVILLE, TN 37923-4204
(865) 694-9886
(865) 694-5023
Mailing address
9430 PARK WEST BLVD STE 240, KNOXVILLE, TN 37923-4204
(865) 694-9886
(865) 694-5023
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3113404
BCBS
TN
Enumeration date
03/19/2007
Last updated
06/22/2020
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