Organization
PEDIATRIC CONSULTANTS WEST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DENISE DEROSSETT (OFFICE MANAGER)
(865) 691-3335
Entity
Organization
Contact information
Practice address
125 HUXLEY RD, KNOXVILLE, TN 37922-3197
(865) 691-3335
(865) 691-3310
Mailing address
PO BOX 440215, NASHVILLE, TN 37244-0215
(865) 670-6199
(865) 670-6188
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518261
—
TN
Enumeration date
03/30/2010
Last updated
12/07/2011
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