MEDICARE: JOHN S WITHERS 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	207P00000X	Emergency Medicine Physician	4328	AK

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

General Provider Information

NPI Number	:	1902893969
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN S WITHERS MD

Provider Business Mailing Address
First Line	:	7450 CHAPMAN HWY STE 220
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37920-6614
Country	:	US
Telephone Number	:	480-442-6446
Fax Number	:

Provider Business Practice Location Address
First Line	:	3125 E SHADOWLAWN AVE NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30305-2405
Country	:	US
Telephone Number	:	404-944-7563
Fax Number	:

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

Provider Enumeration Date	:	10/04/2005
Last Update Date	:	05/05/2026

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