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General NPI Number Information
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NPI Number | 1992967244
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Entity Type | Organization
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Legal Business Name | ANDERSON HEART PHYSICIANS PC
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Dates
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Enumeration Date | 06/27/2008
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Last Update Date | 06/21/2010
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Provider Practice Location Address
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Address Line | 200 NEW YORK AVE SUITE 110
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City | OAK RIDGE
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State | TN
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Zip | 37830-5212
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Country | US
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Telephone | 865-483-1110
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Fax | 865-483-1170
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Provider Business Mailing Address
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Address Line | 200 NEW YORK AVE SUITE 110
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City | OAK RIDGE
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State | TN
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Zip | 37830-5212
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Country | US
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Telephone | 865-483-1110
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Fax | 865-483-1170
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Authorized Official
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Title or Position | OWNER
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Name | STEPHEN MICHAEL TEAGUE
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Credential | M.D.
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Telephone | 865-483-1110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | MD33973
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License Number State | TN
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