Provider Demographics
NPI:1982635314
Name:ABKES, BRUCE A (MD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:A
Last Name:ABKES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2854 STERLING DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-3045
Mailing Address - Country:US
Mailing Address - Phone:423-929-9101
Mailing Address - Fax:423-434-2032
Practice Address - Street 1:215 E WATAUGA AVE
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-4671
Practice Address - Country:US
Practice Address - Phone:423-929-9101
Practice Address - Fax:423-434-2032
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN40775207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNCA7519OtherRAILROAD MEDICARE
TN305485Medicaid
TN4127095OtherBCBS
TNI55777Medicare UPIN
TN305485Medicare ID - Type Unspecified