MEDICARE: DR. JOEL L. FINE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	039791	GA
2	207R00000X	Internal Medicine Physician	55991	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PENDING	OTHER	TN	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083616833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOEL L. FINE MD

Provider Business Mailing Address
First Line	:	1057 VAUGHN CREST DR
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37069-7212
Country	:	US
Telephone Number	:	770-309-8656
Fax Number	:

Provider Business Practice Location Address
First Line	:	1057 VAUGHN CREST DR
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37069-7212
Country	:	US
Telephone Number	:	770-309-8656
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	10/24/2018

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