1184704207 NPI number — OTOLARYNGOLOGY HEAD AND NECK SURGERY ASSOCIATES

Table of content: MISS ERIN MARIE LOUGHERY APRN (NPI 1497012520)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184704207 NPI number — OTOLARYNGOLOGY HEAD AND NECK SURGERY ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OTOLARYNGOLOGY HEAD AND NECK SURGERY ASSOCIATES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1184704207
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11201 WEST POINT DR
Provider Second Line Business Mailing Address:
SUITE 103
Provider Business Mailing Address City Name:
KNOXVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37934-2833
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
865-777-1727
Provider Business Mailing Address Fax Number:
865-966-0942

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11201 WEST POINT DR
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37934-2833
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-777-1727
Provider Business Practice Location Address Fax Number:
865-966-0942
Provider Enumeration Date:
10/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BROWN
Authorized Official First Name:
LEONARD
Authorized Official Middle Name:
W.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
865-777-1727

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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