=====================================================
General NPI Number Information
=====================================================
NPI Number | 1780780882
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROBERT HUGHES MCQUEEN MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/15/2006
-----------------------------------------------------
Last Update Date | 03/02/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 735 MCFARLAND ST
-----------------------------------------------------
City | MORRISTOWN
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37814-3977
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 423-585-5567
-----------------------------------------------------
Fax | 423-585-4669
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 735 MCFARLAND ST
-----------------------------------------------------
City | MORRISTOWN
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37814-3977
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 423-585-5567
-----------------------------------------------------
Fax | 423-857-7655
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number | 9300759
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number | 0101053734
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number | 44852
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------