Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | MD 006873 | TN |
NPI | 1154338218 |
---|---|
Provider Name | Dr. Fred Brown Kaserman |
First Address | Knoxville, TN 37923-4204 |
Second Address | Knoxville, TN 37923-4204 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2006 |
Last Update Date | 03/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2008207 | BCBS OF TN (01) | TN |
3718742 | (05) | TN |
B03209 | (02) |