Provider Demographics
NPI:1376519074
Name:EDMUNDS, MEADE CASTLETON III (MD)
Entity Type:Individual
Prefix:
First Name:MEADE
Middle Name:CASTLETON
Last Name:EDMUNDS
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4713 PAPERMILL DR STE 100
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-1924
Mailing Address - Country:US
Mailing Address - Phone:865-851-7771
Mailing Address - Fax:865-851-7835
Practice Address - Street 1:4713 PAPERMILL DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-1908
Practice Address - Country:US
Practice Address - Phone:865-851-7771
Practice Address - Fax:865-851-7835
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD26426207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ008655Medicaid
TNQ008655Medicaid
3091369Medicare PIN