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:
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Health care specialties

SpecialtyCodeLicense #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 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861439648 NPPES
Tennessee MEDICAID 1513364

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