Individual
DR. TIMOTHY LOGAN GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
8930 CROSS PARK DR STE 2, KNOXVILLE, TN 37923-4713
(865) 218-7474
(865) 218-7475
Mailing address
8930 CROSS PARK DR STE 2, KNOXVILLE, TN 37923-4713
(865) 269-2112
(865) 218-7475
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
DPM 409
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000053556
BCBS
KY
01
—
0191729
BCBS
TN
05
—
3351921
—
TN
05
—
80002017
—
KY
Enumeration date
05/10/2006
Last updated
04/26/2022
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