Individual
MR. TIMOTHY R. BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
10800 PARKSIDE DR STE 330, KNOXVILLE, TN 37934-1926
(865) 218-7480
(865) 218-7488
Mailing address
10800 PARKSIDE DR STE 330, KNOXVILLE, TN 37934-1926
(865) 218-7480
(865) 218-7488
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA772
TN
Other
Enumeration date
07/28/2006
Last updated
07/25/2023
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