Physician Compare National (NPI:1780639021)

HEALTHCARE PROVIDER: STEPHEN MICHAEL TEAGUE MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1780639021
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3375610090
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080923000213
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	TEAGUE
	Individual professional last name
Provider First Name	STEPHEN
	Individual professional first name
Provider Middle Name	M
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1977
	Individual professional's medical school graduation year
Primary Specialty	ORTHOPEDIC SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	KNOXVILLE HMA PHYSICIAN MANAGEMENT, LLC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	6103097316
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	73
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	905 E CENTRAL AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 102
	Group Practice or individual's line 2 address
City	LA FOLLETTE
	Group Practice or individual's city
State	TN
	Group Practice or individual's state
Zip Code	377662768
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	440033
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	LAFOLLETTE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y