Provider Demographics
NPI:1619967239
Name:HOADLEY, STEPHEN (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:
Last Name:HOADLEY
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 1:1225 E WEISGARBER RD
Mailing Address - Street 2:SUITE 190
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-2604
Mailing Address - Country:US
Mailing Address - Phone:865-602-6700
Mailing Address - Fax:865-602-6801
Practice Address - Street 1:900 E OAK HILL AVE
Practice Address - Street 2:SUITE 500
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917-4505
Practice Address - Country:US
Practice Address - Phone:865-525-6688
Practice Address - Fax:865-525-0245
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN18602207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3860440Medicaid
110038584Medicare PIN
KY0644802Medicare PIN
KYP400026148Medicare PIN
P00841510Medicare PIN
TNA99523Medicare UPIN
TN103I066498Medicare PIN
KYK027470Medicare PIN
TN103I060792Medicare PIN
TN3031482Medicare PIN