Provider Demographics
NPI:1235628884
Name:OSCHMAN, KATHRYN VICTORIA KIBLER (OD)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:VICTORIA KIBLER
Last Name:OSCHMAN
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 1:1124 E WEISGARBER RD STE 104
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-2686
Mailing Address - Country:US
Mailing Address - Phone:865-584-0905
Mailing Address - Fax:865-392-5536
Practice Address - Street 1:962 DOLLY PARTON PKWY
Practice Address - Street 2:
Practice Address - City:SEVIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37862-3707
Practice Address - Country:US
Practice Address - Phone:865-428-8000
Practice Address - Fax:865-428-2091
Is Sole Proprietor?:No
Enumeration Date:2018-05-08
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TN3511152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3511OtherTN MEDICAL LICENSE