Provider Demographics
NPI:1003830746
Name:MEANS, ROBERT TAYLOR JR (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:TAYLOR
Last Name:MEANS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 699
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:TN
Mailing Address - Zip Code:37684-0699
Mailing Address - Country:US
Mailing Address - Phone:423-439-7280
Mailing Address - Fax:423-439-7314
Practice Address - Street 1:325 N STATE OF FRANKLIN RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604
Practice Address - Country:US
Practice Address - Phone:423-439-7280
Practice Address - Fax:423-439-7314
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN16949207RH0000X
KY38674207R00000X, 207RH0000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64930423Medicaid
TN3714470OtherGROUP MEDICARE NUMBER
TNQ005891Medicaid
KY0741098Medicare ID - Type Unspecified