Provider Demographics
NPI:1679921696
Name:ALLEN, KATHERINE (OD)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7686 OAK RIDGE HWY
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37931-3335
Mailing Address - Country:US
Mailing Address - Phone:865-247-7715
Mailing Address - Fax:
Practice Address - Street 1:7686 OAK RIDGE HWY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37931-3335
Practice Address - Country:US
Practice Address - Phone:865-247-7715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-31
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOD-T3556152W00000X
GAOPT002930152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist