Individual
MR. LYTLE BROWN V
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1926 ALCOA HWY STE 210, KNOXVILLE, TN 37920-1543
(865) 546-2663
(865) 546-9047
Mailing address
1926 ALCOA HWY STE 210, KNOXVILLE, TN 37920-1543
(865) 546-2663
(865) 546-9047
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2106
TN
363A00000X
Physician Assistant
7027
GA
363AS0400X
Surgical Physician Assistant
2106
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003141595A
—
GA
05
—
1527789
—
TN
01
—
4323446
BLUECROSS BLUESHIELD
TN
Enumeration date
02/29/2012
Last updated
12/01/2020
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