Provider Demographics
NPI:1164858924
Name:SOMMERFELT, CAROL (ELD)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:SOMMERFELT
Suffix:
Gender:F
Credentials:ELD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11126 KINGSTON PIKE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-2806
Mailing Address - Country:US
Mailing Address - Phone:865-777-0088
Mailing Address - Fax:
Practice Address - Street 1:11126 KINGSTON PIKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-2806
Practice Address - Country:US
Practice Address - Phone:865-777-0088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-24
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247ZC0005XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyClinical Laboratory Director, Non-physician