Individual
KURT WERNER WODTKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1819 CLINCH AVE STE 100, KNOXVILLE, TN 37916-2435
(865) 690-4861
Mailing address
PO BOX 306556, NASHVILLE, TN 37230-6556
(865) 694-0062
(865) 694-7907
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7105
TN
Other
Enumeration date
05/05/2026
Last updated
05/05/2026
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