Provider Demographics
NPI:1922093988
Name:PRICE, ROBERT E (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:E
Last Name:PRICE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:200 FORT SANDERS WEST BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-3358
Mailing Address - Country:US
Mailing Address - Phone:865-694-2021
Mailing Address - Fax:865-694-8234
Practice Address - Street 1:200 FORT SANDERS WEST BLVD
Practice Address - Street 2:STE 101
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-3357
Practice Address - Country:US
Practice Address - Phone:865-694-2021
Practice Address - Fax:865-694-8234
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-15
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD022058207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3073686OtherBLUECROSS
TN180037897OtherRAILROAD MEDICARE
TN3065689Medicare PIN
TN3065686Medicare PIN
TN1283940001Medicare NSC
TN30656861Medicare PIN