Blazer, Kevin
Blazer, Kevin is an individual health care provider with primary practice located at 1928 Alcoa Hwy Ste 209 , Knoxville TN 37920-1504. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Blazer, Kevin can be contacted via phone (865) 524-2547.Contact Information
Primary practice address
1928 Alcoa Hwy Ste 209
Knoxville TN 37920-1504
Phone: (865) 524-2547
Fax: (865) 219-5070
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | PA955 | Tennessee |
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA955 | Tennessee |
Profile Details
NPI number | 1861439648 |
---|---|
LBN Legal business name | Blazer, Kevin |
Credentials | Physician's Assistant Certified (PA-C) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 1st, 2006 |
Last updated | Aug 4th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1861439648 | NPPES |
Tennessee | MEDICAID | 1513364 |
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