Provider Demographics
NPI:1871656793
Name:DAUBNER, MICHAEL ALAN (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ALAN
Last Name:DAUBNER
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 1:309 LEATHA LN NW
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312-6444
Mailing Address - Country:US
Mailing Address - Phone:423-728-7020
Mailing Address - Fax:423-479-6130
Practice Address - Street 1:201 DOOLEY ST SE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37311-6220
Practice Address - Country:US
Practice Address - Phone:423-728-7020
Practice Address - Fax:423-479-6130
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN17475207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNA98664Medicare UPIN