Provider Demographics
NPI:1619474855
Name:ALLERGY & ASTHMA AFFILIATES, PC
Entity Type:Organization
Organization Name:ALLERGY & ASTHMA AFFILIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:S
Authorized Official - Last Name:MAVROFF
Authorized Official - Suffix:
Authorized Official - Credentials:
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 1:116 CONCORD RD STE 200
Practice Address - Street 2:
Practice Address - City:FARRAGUT
Practice Address - State:TN
Practice Address - Zip Code:37934-2951
Practice Address - Country:US
Practice Address - Phone:865-525-2640
Practice Address - Fax:865-525-9536
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALLERGY & ASTHMA AFFILIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-04-12
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty