MEDICARE: MICHAEL L NOBLE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	40895	KY
2	207Q00000X	Family Medicine Physician	56262	TN
3	207Q00000X	Family Medicine Physician	MD21033	ME

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205931565
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL L NOBLE MD

Provider Business Mailing Address
First Line	:	4304 CAMRY DR
Second Line	:
City	:	COOKEVILLE
State	:	TN
Zip	:	38501-9618
Country	:	US
Telephone Number	:	859-699-3025
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 PAUL HUFF PKWY NW
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37312-2959
Country	:	US
Telephone Number	:	423-380-6400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	06/17/2022

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