Provider Demographics
NPI:1235410374
Name:ALLERGY & ASTHMA AFFILIATES, PC
Entity Type:Organization
Organization Name:ALLERGY & ASTHMA AFFILIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:TRENT
Authorized Official - Last Name:ELLENBURG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-525-2640
Mailing Address - Street 1:2121 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37916-1111
Mailing Address - Country:US
Mailing Address - Phone:865-525-2640
Mailing Address - Fax:865-525-9536
Practice Address - Street 1:7714 CONNER RD
Practice Address - Street 2:SUITE 108
Practice Address - City:POWELL
Practice Address - State:TN
Practice Address - Zip Code:37849-3559
Practice Address - Country:US
Practice Address - Phone:865-938-7759
Practice Address - Fax:865-938-9620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-02
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty