Provider Demographics
NPI:1578647806
Name:GREATER KNOXVILLE EAR, NOSE AND THROAT ASSOCIATES, PC
Entity Type:Organization
Organization Name:GREATER KNOXVILLE EAR, NOSE AND THROAT ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROSENBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-521-8050
Mailing Address - Street 1:7557A DANNAHER DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:POWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37849-3558
Mailing Address - Country:US
Mailing Address - Phone:865-521-8050
Mailing Address - Fax:865-544-5816
Practice Address - Street 1:7557A DANNAHER DRIVE
Practice Address - Street 2:SUITE 210
Practice Address - City:POWELL
Practice Address - State:TN
Practice Address - Zip Code:37849-3558
Practice Address - Country:US
Practice Address - Phone:865-521-8050
Practice Address - Fax:865-544-5816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & NeckGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3710126Medicare ID - Type Unspecified