Provider Demographics
NPI:1093847816
Name:ASSOCIATED PODIATRY OF KNOXVILLE PC
Entity Type:Organization
Organization Name:ASSOCIATED PODIATRY OF KNOXVILLE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:A
Authorized Official - Last Name:LUBERT
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:865-540-8188
Mailing Address - Street 1:4313 BALL CAMP PIKE
Mailing Address - Street 2:STE 201
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37921-3334
Mailing Address - Country:US
Mailing Address - Phone:865-540-8188
Mailing Address - Fax:865-540-1006
Practice Address - Street 1:4313 BALL CAMP PIKE
Practice Address - Street 2:STE 201
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37921-3334
Practice Address - Country:US
Practice Address - Phone:865-540-8188
Practice Address - Fax:865-540-1006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3952380001Medicare NSC