Basic Information
| Provider Information | |||||||||
| NPI: | 1316949613 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AMBROSE | ||||||||
| FirstName: | PAUL | ||||||||
| MiddleName: | SEABROOK | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1928 ALCOA HWY | ||||||||
| Address2: | STE 324 | ||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379201502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8655249871 | ||||||||
| FaxNumber: | 8653056955 | ||||||||
| Practice Location | |||||||||
| Address1: | 9349 PARK WEST BLVD | ||||||||
| Address2: | STE 105 | ||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379234326 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8656904731 | ||||||||
| FaxNumber: | 8656937484 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2005 | ||||||||
| LastUpdateDate: | 02/06/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | MD0000006952 | TN | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.