Provider Demographics
NPI:1669158218
Name:ASSOCIATED WOUND SPECIALISTS PC
Entity type:Organization
Organization Name:ASSOCIATED WOUND SPECIALISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:HARLEY
Authorized Official - Last Name:ODELL
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:859-810-2840
Mailing Address - Street 1:1328 PAPERMILL POINTE WAY
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-1903
Mailing Address - Country:US
Mailing Address - Phone:865-212-0530
Mailing Address - Fax:865-212-0525
Practice Address - Street 1:2333 ALEXANDRIA DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3215
Practice Address - Country:US
Practice Address - Phone:859-810-2840
Practice Address - Fax:859-810-2842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-27
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Single Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty