Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 0101051116 | VA |
N | 207V00000X | Obstetrician & Gynecologist | MD 27626 | TN |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | MD27626 | TN |
NPI | 1740283688 |
---|---|
Provider Name | Dr. Jeffrey Mcqueary |
First Address | Kingsport, TN 37662-0009 |
Second Address | Bristol, TN 37620-7352 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2005 |
Last Update Date | 18/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010100542 | (05) | VA |
103I086169 | (02) | TN |
3801345 | (05) | TN |
C06181 | (02) | VA |
G28383 | (02) | |
MC10000 | (02) | VA |