Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 55947 | TN |
NPI | 1023374238 |
---|---|
Provider Name | Dr. Nicholas John Panella |
First Address | Knoxville, TN 37923-4203 |
Second Address | Knoxville, TN 37923-4203 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2012 |
Last Update Date | 27/03/2019 |