Provider Demographics
NPI:1821092453
Name:TREON, STEPHEN M (MD,PHD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:M
Last Name:TREON
Suffix:
Gender:M
Credentials:MD,PHD
Other - Prefix:DR
Other - First Name:STEPHEN
Other - Middle Name:MARSHAL
Other - Last Name:TREON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:PO BOX 1107
Mailing Address - Street 2:141 OCOEE
Mailing Address - City:COPPERHILL
Mailing Address - State:TN
Mailing Address - Zip Code:37317-1107
Mailing Address - Country:US
Mailing Address - Phone:423-496-4103
Mailing Address - Fax:423-496-4106
Practice Address - Street 1:141 OCOEE ST
Practice Address - Street 2:
Practice Address - City:COPPERHILL
Practice Address - State:TN
Practice Address - Zip Code:37317
Practice Address - Country:US
Practice Address - Phone:423-496-4103
Practice Address - Fax:423-496-4106
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-10
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000024711207RR0500X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN169300Medicaid
GA85000174GMedicaid
GA00540383AMedicaid
TN169300OtherBCBS
NC890693WMedicaid
TN4415141OtherCIGNA
TN3077645Medicare ID - Type Unspecified
TN169300OtherBCBS
NC890693WMedicaid