Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 38674 | KY |
N | 111NI0900X | Internist | 38674 | KY |
Y | 207RH0000X | Hematologist | 16949 | TN |
N | 207RH0000X | Hematologist | 38674 | KY |
N | 207RH0003X | Hematology & Oncology | 38674 | KY |
NPI | 1003830746 |
---|---|
Provider Name | Robert Taylor Means JR. |
First Address | Mountain Home, TN 37684-0699 |
Second Address | Johnson City, TN 37604 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 30/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3714470 | GROUP MEDICARE NUMBER (01) | TN |
64930423 | (05) | KY |
F35576 | (02) |