MEDICARE: JON C HUEBSCHMAN 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	18398	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	4135890	OTHER	TN	BCBS TN
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	4179052	OTHER	TN	BCBS
6	4179052	OTHER	SC	BCBS

General Provider Information

NPI Number	:	1174597355
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JON C HUEBSCHMAN MD

Provider Business Mailing Address
First Line	:	1060 PEERLESS CROSSING DR
Second Line	:	SUITE 200
City	:	CLEVELAND
State	:	TN
Zip	:	37312-3784
Country	:	US
Telephone Number	:	423-479-4165
Fax Number	:	423-478-1884

Provider Business Practice Location Address
First Line	:	1060 PEERLESS CROSSING DR
Second Line	:	SUITE 200
City	:	CLEVELAND
State	:	TN
Zip	:	37312-3784
Country	:	US
Telephone Number	:	423-479-4165
Fax Number	:	423-478-1884

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

Provider Enumeration Date	:	02/15/2006
Last Update Date	:	09/04/2020

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Directions to “ JON C HUEBSCHMAN MD” Practice Location

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