Organization
LOUDON COUNTY PEDIATRICS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DWIGHT DANIEL BIVENS (SECRETARY/TREASURER)
(865) 986-9233
Entity
Organization
Contact information
Practice address
423 MEDICAL PARK DR, LENOIR CITY, TN 37772-5640
(865) 986-9233
(865) 986-0148
Mailing address
423 MEDICAL PARK DR, LENOIR CITY, TN 37772-5640
(865) 986-9233
(865) 986-0148
Taxonomy
Speciality
Code
Description
License number
State
364SP0200X
Pediatric Clinical Nurse Specialist
Primary
145961
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1265462287
NPPES
TN
01
—
1841514155
NPPES
TN
Enumeration date
05/06/2010
Last updated
05/06/2010
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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