Organization · Type 2 NPI

East Tennessee Children's Hospital Association, Inc.

Plastic and Reconstructive Surgery Physician · Knoxville, TN

NPI number 1003494352 Active

Practice location

2100 Clinch Ave Ste 510
Knoxville, TN 37916-2225

Call (865) 824-4939 Map

Fax (866) 630-2013

Mailing address

PO Box 50068
Knoxville, TN 37950-0068

Specialties and licenses

TaxonomyCodeLicense
Pediatrics Physician 208000000XNone listed
Plastic Surgery Physician 208200000XNone listed
Pediatric Surgery Physician 2086S0120XNone listed
Plastic and Reconstructive Surgery Physician Primary 2086S0122XNone listed
Physician Assistant 363A00000XNone listed
Surgical Physician Assistant 363AS0400XNone listed

Plastic and Reconstructive Surgery Physician: A surgeon who specializes in plastic and reconstructive surgery.

6 other providers at this address

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About NPI 1003494352

East Tennessee Children's Hospital Association, Inc.'s National Provider Identifier is 1003494352, issued on Mar 30, 2021. The primary taxonomy on file is Plastic and Reconstructive Surgery Physician (2086S0122X), and the practice location is in Knoxville, TN. The record was last updated on Sep 5, 2026.