Provider Demographics
NPI:1124214721
Name:MICHAEL F. LETT, M.D. P.C.
Entity Type:Organization
Organization Name:MICHAEL F. LETT, M.D. P.C.
Other - Org Name:MICHAEL F. LETT, M.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:F
Authorized Official - Last Name:LETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-966-8770
Mailing Address - Street 1:11730 KINGSTON PIKE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-3827
Mailing Address - Country:US
Mailing Address - Phone:865-966-8770
Mailing Address - Fax:865-777-3937
Practice Address - Street 1:11730 KINGSTON PIKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-3827
Practice Address - Country:US
Practice Address - Phone:865-966-8770
Practice Address - Fax:865-777-3937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-18
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN12161207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNB04777Medicare UPIN
TN3732373Medicare PIN