1114975356 NPI number — ANGELA E MEADOWS M.D.

Table of content: ANGELA E MEADOWS M.D. (NPI 1114975356)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114975356 NPI number — ANGELA E MEADOWS M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MEADOWS
Provider First Name:
ANGELA
Provider Middle Name:
E
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114975356
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/08/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1225 E WEISGARBER RD
Provider Second Line Business Mailing Address:
ST. 200
Provider Business Mailing Address City Name:
KNOXVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37909-2604
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
865-584-4747
Provider Business Mailing Address Fax Number:
865-584-1363

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1420 NORTH GATEWAY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCKWOOD
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37854-6543
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-354-7799
Provider Business Practice Location Address Fax Number:
865-354-7797
Provider Enumeration Date:
05/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  MD35022 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0000211007401 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 3706633 . This is a "MEDICARE GROUP" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 110228642 . This is a "RAILROAD PROVIDER" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 7209165 . This is a "CIGNA" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 100035915 . This is a "PHP TN CARE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: TN0101 . This is a "JOHN DEERE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 4018566 . This is a "BCBS" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 2121254546001 . This is a "BEECHSTREET" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".




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