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NPI Code Detail

MEDICARE: DR. GEORGE ROBERT BADDOUR JR. M.D.

MEDICARE: DR. GEORGE ROBERT BADDOUR JR. M.D.
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
1207X00000XOrthopaedic Surgery PhysicianMD12140TN
2207XX0801XOrthopaedic Trauma Physician12140TN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
6200030080OTHERTNRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10940072OTHERTNUNITED HEALTH CARE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
33071400OTHERTNBLUE CROSS BLUE SHIELD
4100021943OTHERTNTENNCARE
5419940880OTHERTNTRICARE
7TN0111OTHERTNJOHN DEERE HEALTHCARE
8TN0112OTHERTNJOHN DEERE HEALTHCARE
9TN0175OTHERTNJOHN DEERE HEALTHCARE
104664594OTHERTNAETNA

General Provider Information

NPI Number : 1518934579
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GEORGE ROBERT BADDOUR JR. M.D.
Provider Business Mailing Address
First Line : 1926 ALCOA HWY
Second Line : BLDG. F, SUITE 210
City : KNOXVILLE
State : TN
Zip : 37920-1545
Country : US
Telephone Number : 865-546-2663
Fax Number : 865-546-9047
Provider Business Practice Location Address
First Line : 1926 ALCOA HWY
Second Line : BLDG. F, SUITE 210
City : KNOXVILLE
State : TN
Zip : 37920-1545
Country : US
Telephone Number : 865-546-2663
Fax Number : 865-546-9047
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2006
Last Update Date : 03/07/2017

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