Gaddis, Roger Dale
Gaddis, Roger Dale is an individual health care provider with primary practice located at 266 Joule St , Alcoa TN 37701-2422. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Gaddis, Roger Dale can be contacted via phone (865) 984-3864.Contact Information
Primary practice address
266 Joule St
Alcoa TN 37701-2422
Phone: (865) 984-3864
Fax: (865) 380-4095
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | DO0000001730 | Tennessee |
Profile Details
| NPI number | 1902009699 |
|---|---|
| LBN Legal business name | Gaddis, Roger Dale |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 8th, 2007 |
| Last updated | Jan 13th, 2015 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1902009699 | NPPES |
| Tennessee | MEDICAID | 4334952 | |
| Tennessee | MEDICAID | 1513698 |
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