Organization
SOUTHEASTERN RETINA ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDREW LAVERGHETTA CEO (CEO)
(865) 588-0811
Entity
Organization
Contact information
Practice address
1342 OLD WEISGARBER RD, KNOXVILLE, TN 37909-1291
(865) 588-0811
Mailing address
9050 EXECUTIVE PARK DR STE 202A, KNOXVILLE, TN 37923-4670
(865) 588-0811
(865) 934-3892
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
—
TN
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3850174
—
TN
01
—
CD7808
RAILROAD MEDICARE
TN
01
—
CG2897
RAILROAD MEDICARE
VA
01
—
CL1229
RAILROAD MEDICARE
TN
Enumeration date
09/26/2006
Last updated
10/22/2025
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