Provider Demographics
NPI:1053498691
Name:ZOLMAN, MAX E (OD)
Entity Type:Individual
Prefix:DR
First Name:MAX
Middle Name:E
Last Name:ZOLMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7346 OXMOOR RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37931-1842
Mailing Address - Country:US
Mailing Address - Phone:865-938-1770
Mailing Address - Fax:
Practice Address - Street 1:6777 CLINTON HWY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37912-1020
Practice Address - Country:US
Practice Address - Phone:865-938-6769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOD936152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3595369Medicaid
TN3595369Medicaid
TN3595369Medicare ID - Type Unspecified