Individual
DR. MARK Y. IVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4528 CHAPMAN HWY, KNOXVILLE, TN 37920-4359
(865) 579-3920
(865) 579-3918
Mailing address
4528 CHAPMAN HWY, KNOXVILLE, TN 37920-4359
(865) 579-3920
(865) 579-3963
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD11712
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3199121
—
TN
Enumeration date
11/14/2005
Last updated
06/22/2020
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