Healthcare Provider Details

I. General information

NPI: 1558524504
Provider Name (Legal Business Name): JOHN THOMAS MEADOWS JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2008
Last Update Date: 06/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1930 ALCOA HWY SUITE 145
KNOXVILLE TN
37920-1500
US

IV. Provider business mailing address

1930 ALCOA HWY SUITE 145
KNOXVILLE TN
37920-1500
US

V. Phone/Fax

Practice location:
  • Phone: 865-582-3114
  • Fax:
Mailing address:
  • Phone: 865-582-3114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number40745
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number46073
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: