Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | PA0000003574 | TN |
NPI | 1275039661 |
---|---|
Provider Name | Mekia Truclaye Kauffman |
First Address | Knoxville, TN 37920-1524 |
Second Address | Knoxville, TN 37920-1524 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2018 |
Last Update Date | 04/04/2018 |