Provider Demographics
NPI:1316949613
Name:AMBROSE, PAUL SEABROOK (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:SEABROOK
Last Name:AMBROSE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1928 ALCOA HWY
Mailing Address - Street 2:STE 324
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1502
Mailing Address - Country:US
Mailing Address - Phone:865-524-9871
Mailing Address - Fax:865-305-6955
Practice Address - Street 1:9349 PARK WEST BLVD
Practice Address - Street 2:STE 105
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4326
Practice Address - Country:US
Practice Address - Phone:865-690-4731
Practice Address - Fax:865-693-7484
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2013-02-06
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Provider Licenses
StateLicense IDTaxonomies
TNMD0000006952207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNB02964Medicare UPIN
103I182002Medicare PIN