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NPI Code Detail

MEDICARE: ISHAM C HEWGLEY, III MD

MEDICARE: ISHAM C HEWGLEY, III 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
1208M00000XHospitalist Physician16850TN
2207R00000XInternal Medicine Physician16850TN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00986579OTHERTNRR MEDICARE

Other Identifiers

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

General Provider Information

NPI Number : 1215915921
Entity Type Code : Individual
Provider Name (Legal Business Name) : ISHAM C HEWGLEY, III MD
Provider Business Mailing Address
First Line : 10820 PARKSIDE DR
Second Line : 2ND FLOOR
City : KNOXVILLE
State : TN
Zip : 37934-1956
Country : US
Telephone Number : 865-218-7972
Fax Number : 865-218-7973
Provider Business Practice Location Address
First Line : 10820 PARKSIDE DR
Second Line : 2ND FLOOR
City : KNOXVILLE
State : TN
Zip : 37934-1956
Country : US
Telephone Number : 865-218-7972
Fax Number : 865-218-7973
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2006
Last Update Date : 05/03/2013

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