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NPI Code Detail

MEDICARE: DR. GREGORY MARK MATHIEN M.D.

MEDICARE: DR. GREGORY MARK MATHIEN 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
1207XX0005XSports Medicine (Orthopaedic Surgery) Physician21414TN
2207X00000XOrthopaedic Surgery PhysicianMD21414TN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
7200030088OTHERTNRAILROAD MEDICARE
10P00910368OTHERTNRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1TN0120OTHERTNJOHN DEERE HEALTHCARE
2100010064OTHERTNTENNCARE
31196196OTHERTNUNITED HEALTH CARE
4TN0152OTHERTNJOHN DEERE HEALTHCARE
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
64397728OTHERTNAETNA
83071385OTHERTNBLUE CROSS BLUE SHIELD
9098041241OTHERTNTRICARE

General Provider Information

NPI Number : 1730156076
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GREGORY MARK MATHIEN M.D.
Provider Business Mailing Address
First Line : 8320 E WALKER SPRINGS LN STE 200
Second Line :
City : KNOXVILLE
State : TN
Zip : 37923-3120
Country : US
Telephone Number : 865-769-4500
Fax Number : 865-769-4501
Provider Business Practice Location Address
First Line : 1422 OLD WEISGARBER RD
Second Line :
City : KNOXVILLE
State : TN
Zip : 37909-1293
Country : US
Telephone Number : 865-558-4400
Fax Number : 865-558-4471
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2006
Last Update Date : 01/15/2026

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