Provider Demographics
NPI:1235213059
Name:MATTHEWS, WILLIAM E (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:E
Last Name:MATTHEWS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5022 OLD GODSEY LN
Mailing Address - Street 2:SUITE 8
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-6600
Mailing Address - Country:US
Mailing Address - Phone:423-875-0793
Mailing Address - Fax:423-876-7456
Practice Address - Street 1:5022 OLD GODSEY LN
Practice Address - Street 2:SUITE 8
Practice Address - City:HIXSON
Practice Address - State:TN
Practice Address - Zip Code:37343-6604
Practice Address - Country:US
Practice Address - Phone:423-875-0793
Practice Address - Fax:423-876-7456
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD12538207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN621205293OtherTAX ID
TN0036108OtherBLUE CROSS BLUE SHIELD
TNTN0101OtherJOHN DEERE
TN200002208OtherRAILROAD MEDICARE
3008757Medicare PIN
TN621205293OtherTAX ID
TND70058Medicare UPIN