Organization
KNOXVILLE CENTER FOR DERMATOLOGY AND PLASTIC SURGERY, PL
Active
Organization
KNOXVILLE CENTER FOR DERMATOLOGY AND PLASTIC SURGERY, PL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL P. FOWLER MD (OWNER)
(865) 470-4124
Entity
Organization
Contact information
Practice address
9430 PARK WEST BLVD STE 240, KNOXVILLE, TN 37923
(865) 470-4127
(833) 790-3693
Mailing address
PO BOX 11268, KNOXVILLE, TN 37939-1268
(865) 470-4127
(833) 790-3693
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q035060
—
TN
Enumeration date
03/16/2018
Last updated
06/05/2018
Update your record
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