Provider Demographics
NPI:1114975356
Name:MEADOWS, ANGELA E (MD)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:E
Last Name:MEADOWS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 E WEISGARBER RD
Mailing Address - Street 2:ST. 200
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-2604
Mailing Address - Country:US
Mailing Address - Phone:865-584-4747
Mailing Address - Fax:865-584-1363
Practice Address - Street 1:1420 NORTH GATEWAY AVE
Practice Address - Street 2:
Practice Address - City:ROCKWOOD
Practice Address - State:TN
Practice Address - Zip Code:37854-6543
Practice Address - Country:US
Practice Address - Phone:865-354-7799
Practice Address - Fax:865-354-7797
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD35022207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0000211007401OtherUNITED HEALTHCARE
TN3706633OtherMEDICARE GROUP
TN110228642OtherRAILROAD PROVIDER
TN7209165OtherCIGNA
TN100035915OtherPHP TN CARE
TNTN0101OtherJOHN DEERE
TN4018566OtherBCBS
TN2121254546001OtherBEECHSTREET
TN100035915OtherPHP TN CARE
TNH40764Medicare UPIN