Provider Demographics
NPI:1629071972
Name:BLOW, JOANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:
Last Name:BLOW
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 1:201 FOREST HILLS DR
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:TN
Mailing Address - Zip Code:37620-2708
Mailing Address - Country:US
Mailing Address - Phone:423-968-5018
Mailing Address - Fax:423-968-2934
Practice Address - Street 1:201 FOREST HILLS DR
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:TN
Practice Address - Zip Code:37620-2708
Practice Address - Country:US
Practice Address - Phone:423-968-5018
Practice Address - Fax:423-968-2934
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-31
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD 39184208000000X
VA0101237513208000000X
TN39184207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3326620Medicaid
TN3326620Medicare ID - Type Unspecified
F43405Medicare UPIN
VA006419H12Medicare ID - Type Unspecified
TN1629071972Medicare PIN