Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | MD12538 | TN |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | MD12538 | TN |
NPI | 1235213059 |
---|---|
Provider Name | William E Matthews |
First Address | Hixson, TN 37343-6600 |
Second Address | Hixson, TN 37343-6604 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 19/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0036108 | BLUE CROSS BLUE SHIELD (01) | TN |
200002208 | RAILROAD MEDICARE (01) | TN |
621205293 | TAX ID (01) | TN |
D70058 | (02) | TN |
TN0101 | JOHN DEERE (01) | TN |