Provider Demographics
NPI:1831135730
Name:TONEY, LEE E III (MD)
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:E
Last Name:TONEY
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:LEE
Other - Middle Name:BERT
Other - Last Name:TONEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1275 DICK LONAS RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-1382
Mailing Address - Country:US
Mailing Address - Phone:865-584-4747
Mailing Address - Fax:
Practice Address - Street 1:7545 BARNETT WAY
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:TN
Practice Address - Zip Code:37849-3565
Practice Address - Country:US
Practice Address - Phone:865-824-1524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14479207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN080178105OtherRR MEDICARE PIN
TN3809914Medicaid
B04812Medicare UPIN
TN3809915Medicare ID - Type UnspecifiedLEGACY PIN
TN3717544Medicare ID - Type UnspecifiedLEGACY GROUP