Provider Demographics
NPI:1891714002
Name:MEYETTE, PHILIP FRANK (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:FRANK
Last Name:MEYETTE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1225 E WEISGARBER RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-2604
Mailing Address - Country:US
Mailing Address - Phone:865-584-4747
Mailing Address - Fax:865-584-1363
Practice Address - Street 1:2240 SUTHERLAND AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-2333
Practice Address - Country:US
Practice Address - Phone:865-909-0090
Practice Address - Fax:865-909-9883
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2017-01-26
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Provider Licenses
StateLicense IDTaxonomies
TN41294207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ018223Medicaid
TN103I087309Medicare PIN
TNQ018223Medicaid