Provider Demographics
NPI:1487671350
Name:MCNIEL, JANET S (MD)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:S
Last Name:MCNIEL
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 1:5917 RUTLEDGE PIKE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37924-2252
Mailing Address - Country:US
Mailing Address - Phone:865-525-2121
Mailing Address - Fax:865-525-7892
Practice Address - Street 1:5917 RUTLEDGE PIKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37924-2252
Practice Address - Country:US
Practice Address - Phone:865-525-2121
Practice Address - Fax:865-525-7892
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000016150207Q00000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN003064435OtherBCBS OF TN
TN3016063Medicare ID - Type Unspecified
TNA98008Medicare UPIN