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General NPI Number Information
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NPI Number | 1144253469
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Entity Type | Organization
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Legal Business Name | BEARDEN HEALTHCARE ASSOCIATES INC
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 06/05/2017
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Provider Practice Location Address
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Address Line | 10321 KINGSTON PIKE
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City | KNOXVILLE
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State | TN
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Zip | 37922-3224
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Country | US
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Telephone | 865-584-3565
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Fax | 865-584-2956
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Provider Business Mailing Address
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Address Line | 10321 KINGSTON PIKE
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City | KNOXVILLE
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State | TN
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Zip | 37922-3224
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Country | US
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Telephone | 865-584-3565
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Fax | 865-584-2956
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Authorized Official
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Title or Position | CHIROPRACTIC PHYSICIAN/OWNER
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Name | GLENN D JOHNSON
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Credential | DC
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Telephone | 865-584-3565
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC0000000705
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC0000000766
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | MD53866
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD0000016119
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License Number State | TN
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Taxonomy #5
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | MD53866
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License Number State | TN
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Taxonomy #6
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State | TN
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