Provider Demographics
NPI:1609294339
Name:MAHONY, JEFFREY NEWTON (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:NEWTON
Last Name:MAHONY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JEFF
Other - Middle Name:
Other - Last Name:MAHONY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 11167
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37939-1167
Mailing Address - Country:US
Mailing Address - Phone:865-584-7376
Mailing Address - Fax:865-540-3856
Practice Address - Street 1:1924 ALCOA HWY # U107
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1511
Practice Address - Country:US
Practice Address - Phone:865-305-9661
Practice Address - Fax:865-305-6148
Is Sole Proprietor?:No
Enumeration Date:2014-03-31
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TN568472085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program