| Dr Tidence Lane Prince, MD | |
|
616 W. Lamar Alexander Parkway, Maryville, TN 37801-4763 | |
| (865) 273-0008 | |
| Not Available |
| Full Name | Dr Tidence Lane Prince |
|---|---|
| Gender | Male |
| Speciality | Allergy/immunology |
| Experience | 36 Years |
| Location | 616 W. Lamar Alexander Parkway, Maryville, Tennessee |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215922356 | NPI | - | NPPES |
| 3068515 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207K00000X | Allergy & Immunology | 21247 (Tennessee) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Blount Memorial Hospital | Maryville, TN | Hospital |
| Parkwest Medical Center | Knoxville, TN | Hospital |
| Fort Loudoun Medical Center | Lenoir city, TN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Allergy, Asthma, Immunology Center - Ty Prince, Pllc | 3274068234 | 10 |
| Entity Name | Allergy Associates, Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073508347 PECOS PAC ID: 1355246398 Enrollment ID: O20081105000386 |
| Entity Name | Allergy, Asthma, Immunology Center - Ty Prince, Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1114752821 PECOS PAC ID: 3274068234 Enrollment ID: O20241127001922 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Tidence Lane Prince, MD 616 W. Lamar Alexander Parkway, Maryville, TN 37801-7360 Ph: (865) 273-0008 | Dr Tidence Lane Prince, MD 616 W. Lamar Alexander Parkway, Maryville, TN 37801-4763 Ph: (865) 273-0008 |
Dr. Wilson Scout Robinson Jr., MD Allergy & Immunology Medicare: Accepting Medicare Assignments Practice Location: 616 W Lamar Alexander Pkwy, Maryville, TN 37801 Phone: 865-273-0008 Fax: 865-895-4090 |