Provider Demographics
NPI:1821025784
Name:FINNEGAN, MARTIN (MD)
Entity type:Individual
Prefix:
First Name:MARTIN
Middle Name:
Last Name:FINNEGAN
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:PO BOX 52690
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37950-2690
Mailing Address - Country:US
Mailing Address - Phone:865-766-8800
Mailing Address - Fax:865-450-9374
Practice Address - Street 1:2333 MCCALLIE AVE
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-3258
Practice Address - Country:US
Practice Address - Phone:423-493-1387
Practice Address - Fax:423-553-1224
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN352022085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000946382Medicaid
TN300131268OtherRR MCARE-ADR
TN4022315OtherPLAZA BC/BS OF TN
AL009918735Medicaid
TN4022310OtherADR BC/BS OF TN
TN300131267OtherRR MCARE-CI
TN3865392Medicare PIN
TN3865390Medicare PIN
TN4022315OtherPLAZA BC/BS OF TN
TN300131267OtherRR MCARE-CI
TN300131267Medicare PIN