Provider Demographics
NPI:1972792190
Name:KITCHENS, WILLIAM (CO)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:KITCHENS
Suffix:
Gender:M
Credentials:CO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:314 ERIN DR STE 101
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-6210
Mailing Address - Country:US
Mailing Address - Phone:865-588-4256
Mailing Address - Fax:865-588-4355
Practice Address - Street 1:314 ERIN DR STE 101
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-6210
Practice Address - Country:US
Practice Address - Phone:865-588-4256
Practice Address - Fax:865-588-4355
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-24
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment