Provider Demographics
NPI:1356332126
Name:METCALF, JOSEPH IV (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:METCALF
Suffix:IV
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 1:988 OAK RIDGE TPKE
Mailing Address - Street 2:SUITE 350
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-6930
Mailing Address - Country:US
Mailing Address - Phone:865-483-7030
Mailing Address - Fax:865-483-3954
Practice Address - Street 1:988 OAK RIDGE TPKE
Practice Address - Street 2:SUITE 350
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-6930
Practice Address - Country:US
Practice Address - Phone:865-483-7030
Practice Address - Fax:865-483-3954
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD021506208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TND80562Medicare UPIN
TN3060597Medicare PIN