Basic Information
| Provider Information | |||||||||
| NPI: | 1942892591 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UNKEFER DERMATOLOGY, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 306426 | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372306426 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8656706199 | ||||||||
| FaxNumber: | 8656706198 | ||||||||
| Practice Location | |||||||||
| Address1: | 125 MOUNTAIN VIEW DR STE 300 | ||||||||
| Address2: | |||||||||
| City: | VONORE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 378852666 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4238842971 | ||||||||
| FaxNumber: | 4238842984 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/05/2021 | ||||||||
| LastUpdateDate: | 02/05/2021 | ||||||||
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| AuthorizedOfficialLastName: | UNKEFER | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
| AuthorizedOfficialMiddleName: | P | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4238842971 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 02/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.