Healthcare Provider Details

I. General information

NPI: 1114975356
Provider Name (Legal Business Name): ANGELA E MEADOWS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 10/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 NORTH GATEWAY AVE
ROCKWOOD TN
37854-6543
US

IV. Provider business mailing address

1225 E WEISGARBER RD ST. 200
KNOXVILLE TN
37909-2604
US

V. Phone/Fax

Practice location:
  • Phone: 865-354-7799
  • Fax: 865-354-7797
Mailing address:
  • Phone: 865-584-4747
  • Fax: 865-584-1363

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD35022
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: