Provider Demographics
NPI:1811145584
Name:AVERY, JOEL EUGENE (MD)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:EUGENE
Last Name:AVERY
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 1:15 HIDDEN BROOK LANE
Mailing Address - Street 2:
Mailing Address - City:SIGNAL MTN
Mailing Address - State:TN
Mailing Address - Zip Code:37377
Mailing Address - Country:US
Mailing Address - Phone:423-886-4786
Mailing Address - Fax:
Practice Address - Street 1:15 HIDDEN BROOK LANE
Practice Address - Street 2:
Practice Address - City:SIGNAL MTN
Practice Address - State:TN
Practice Address - Zip Code:37377
Practice Address - Country:US
Practice Address - Phone:423-886-4786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-05
Last Update Date:2008-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000008674208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)