MEDICARE: DR. MELODY COUNTS 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
1	207Q00000X	Family Medicine Physician	0101233837	VA
2	207QA0401X	Addiction Medicine (Family Medicine) Physician	63783	TN
3	207Q00000X	Family Medicine Physician	63783	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P01265431	OTHER	VA	RAILROAD MEDICARE

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
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811994700
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MELODY COUNTS M.D.

Provider Business Mailing Address
First Line	:	407 4TH ST
Second Line	:
City	:	NEWPORT
State	:	TN
Zip	:	37821-3762
Country	:	US
Telephone Number	:	423-623-6240
Fax Number	:	423-623-0102

Provider Business Practice Location Address
First Line	:	407 4TH ST
Second Line	:
City	:	NEWPORT
State	:	TN
Zip	:	37821-3762
Country	:	US
Telephone Number	:	423-623-6240
Fax Number	:	423-623-0102

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

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	05/03/2023

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Directions to “ DR. MELODY COUNTS M.D.” Practice Location

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