Provider Demographics
NPI:1336321066
Name:MCCURLEY, BETH ANNA (MD)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:ANNA
Last Name:MCCURLEY
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:PO BOX 3889
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37602-3889
Mailing Address - Country:US
Mailing Address - Phone:423-794-5742
Mailing Address - Fax:423-283-9480
Practice Address - Street 1:301 MED TECH PKWY STE 280
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-2641
Practice Address - Country:US
Practice Address - Phone:423-794-5550
Practice Address - Fax:423-794-5867
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000045281207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1336321066Medicaid
KY7100245530Medicaid
TNP00924035OtherRAILROAD MEDICARE
TN1516105Medicaid
TNP00925984OtherRAILROAD MEDICARE
VA1336321066Medicaid
NC1336321066Medicaid