Provider Demographics
NPI:1760656797
Name:ALLERGY ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:ALLERGY ASSOCIATES, P.A.
Other - Org Name:THE ALLERGY, ASTHMA & SINUS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:OVERHOLT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-584-8588
Mailing Address - Street 1:6701 BAUM DR
Mailing Address - Street 2:SUITE 140
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-7360
Mailing Address - Country:US
Mailing Address - Phone:865-584-5727
Mailing Address - Fax:865-450-9904
Practice Address - Street 1:1317 CUMBERLAND FALLS HWY
Practice Address - Street 2:SUITE A
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-2720
Practice Address - Country:US
Practice Address - Phone:865-584-8588
Practice Address - Fax:865-584-3364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-22
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY26755174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY3527Medicare PIN