Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 56472 | TN |
NPI | 1215290713 |
---|---|
Provider Name | Dr. Laura Sawyer Green |
First Address | Knoxville, TN 37919-7361 |
Second Address | Knoxville, TN 37909-2707 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2012 |
Last Update Date | 31/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Q034862 | (05) | TN |