Dr. Tidence Lane Prince
Allergist & Immunologist
611 Morganton Square Dr
Maryville
, Tennessee 37801-4763
Dr. Tidence Lane Prince
Allergist & Immunologist
611 Morganton Square Dr
Maryville
, Tennessee 37801-4763
(865) 450-9904
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About
Features
Specialties
- Allergist & Immunologist
Languages spoken
- English
Location
First Address
- Dr. Tidence Lane Prince
- 6701 Baum Dr Suite 140
- Knoxville, TN
- Zip : 37919-7360
- Fax : (865) 450-9904
- Phone : (865) 584-5727
Second Address
- Dr. Tidence Lane Prince
- 611 Morganton Square Dr
- Maryville, TN
- Zip : 37801-4763
- Fax : (865) 584-3364
- Phone : (865) 584-8588
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207K00000X | Allergist & Immunologist | 21247 | TN |
National Provider Identifier
| NPI | 1215922356 |
|---|---|
| Provider Name | Dr. Tidence Lane Prince |
| First Address | Knoxville, TN 37919-7360 |
| Second Address | Maryville, TN 37801-4763 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 14/09/2005 |
| Last Update Date | 08/02/2018 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 3068515 | (05) | TN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.