Provider Demographics
NPI:1780780882
Name:MCQUEEN, ROBERT HUGHES (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:HUGHES
Last Name:MCQUEEN
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 1:735 MCFARLAND ST
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-3977
Mailing Address - Country:US
Mailing Address - Phone:423-585-5567
Mailing Address - Fax:423-857-7655
Practice Address - Street 1:735 MCFARLAND ST
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-3977
Practice Address - Country:US
Practice Address - Phone:423-585-5567
Practice Address - Fax:423-585-4669
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9300759207RC0000X
VA0101053734207RC0000X
TN44852207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4223133OtherBCBS
KY7100075650Medicaid
VA1780780882Medicaid
TN1514274Medicaid
TN1514275Medicaid
TNP01747958OtherRAILROAD MEDICARE
TN1514275Medicaid
VA019464B12Medicare PIN