Healthcare Provider Details

I. General information

NPI: 1396787495
Provider Name (Legal Business Name): WILLIAM E MEADOWS III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 01/30/2020
Certification Date: 01/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 HAMILTON PLACE BLVD G
CHATTANOOGA TN
37421-6046
US

IV. Provider business mailing address

6170 SHALLOWFORD RD 101
CHATTANOOGA TN
37421-1892
US

V. Phone/Fax

Practice location:
  • Phone: 423-899-6222
  • Fax: 423-490-0294
Mailing address:
  • Phone: 423-648-4500
  • Fax: 423-855-7563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number30513
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD0000014303
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number30513
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: