Individual
DR. KHALED OTHMAN ABUMAYALEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1030 HUNTERS CROSSING LANE, ALCOA, TN 37701
(865) 984-1100
(865) 984-8305
Mailing address
761 FOX LANDING LANE, KNOXVILLE, TN 37922
(865) 671-6127
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1827
GA
152W00000X
Optometrist
Primary
1848
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1847
TN LICENSE
TN
Enumeration date
02/13/2007
Last updated
07/08/2007
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