Provider Demographics
NPI:1407977184
Name:STAUFFER, MEGAN PARTRIDGE (MD)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:PARTRIDGE
Last Name:STAUFFER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MEGAN
Other - Middle Name:ELIZABETH
Other - Last Name:PARTRIDGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6701 BAUM DR
Mailing Address - Street 2:SUITE 140
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-7360
Mailing Address - Country:US
Mailing Address - Phone:865-584-5727
Mailing Address - Fax:865-450-9904
Practice Address - Street 1:5045 OLD HICKORY BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-2582
Practice Address - Country:US
Practice Address - Phone:615-475-0148
Practice Address - Fax:615-475-0151
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD42437174400000X
TN42437207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3000930Medicare PIN