Provider Demographics
NPI:1558467951
Name:DERMATOLOGY ASSOCIATES OF OAK RIDGE,PC
Entity Type:Organization
Organization Name:DERMATOLOGY ASSOCIATES OF OAK RIDGE,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DERMATOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHARP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-482-2129
Mailing Address - Street 1:800 OAK RIDGE TPKE
Mailing Address - Street 2:SUITE A300
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-6957
Mailing Address - Country:US
Mailing Address - Phone:865-482-2129
Mailing Address - Fax:865-482-4036
Practice Address - Street 1:800 OAK RIDGE TPKE
Practice Address - Street 2:SUITE A300
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-6957
Practice Address - Country:US
Practice Address - Phone:865-482-2129
Practice Address - Fax:865-482-4036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN=========OtherTAX ID NUMBER
TN3387432Medicare ID - Type UnspecifiedGROUP ID NUMBER