Provider Demographics
NPI:1467422808
Name:MEADOWS, MICHAEL L (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:L
Last Name:MEADOWS
Suffix:
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 1:2001 LAUREL AVE N304
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37916
Mailing Address - Country:US
Mailing Address - Phone:865-766-6870
Mailing Address - Fax:865-766-0133
Practice Address - Street 1:2001 LAUREL AVE N304
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37916-2022
Practice Address - Country:US
Practice Address - Phone:865-766-6870
Practice Address - Fax:865-766-0133
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN583712085R0202X
WV180972085B0100X, 2085R0202X
DCMD0468082085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH242044Medicaid
KY2480976OtherKY WELLCARE MEDICAID
TNQ071319Medicaid
5074139OtherAETNA
KY7100725910Medicaid
OH242044Medicaid