# KENNETH MATHEWS JR MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750460515
- **Authorized official:** DR. KENNETH MILTON MATHEWS JR. MD MSPH FACPM (PRESIDENT OWNER)
- **Authorized official phone:** (423) 581-3490

## Contact information

- **Practice address:** 812 WEST 4TH NORTH ST, MORRISTOWN, TN 37814
- **Practice address phone:** (423) 581-3490
- **Practice address fax:** (423) 581-0657
- **Mailing address:** 812 WEST 4TH NORTH ST, MORRISTOWN, TN 37814
- **Mailing address phone:** (423) 581-3490
- **Mailing address fax:** (423) 581-0657

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207P00000X | Emergency Medicine Physician | MD012570TN | TN | — |
| 207P00000X | Emergency Medicine Physician | MD9700433NC | NC | — |
| 207Q00000X | Family Medicine Physician | MD012570TN | TN | — |
| 207Q00000X | Family Medicine Physician | MD9700433NC | NC | — |
| 207R00000X | Internal Medicine Physician | 9700433NC | NC | — |
| 207R00000X | Internal Medicine Physician | MD012570TN | TN | — |
| 2083P0500X | Preventive Medicine/Occupational Environmental Medicine Physician | MD012570TN | TN | — |
| 2083P0500X | Preventive Medicine/Occupational Environmental Medicine Physician | MD9700433NC | NC | — |
| 2083P0901X | Public Health & General Preventive Medicine Physician | 9700433NC | NC | Yes |
| 2083P0901X | Public Health & General Preventive Medicine Physician | MD012570TN | TN | — |
| 208D00000X | General Practice Physician | 9700433NC | NC | — |
| 208D00000X | General Practice Physician | MD012570TN | TN | — |

## Other

- **Enumeration date:** 11/03/2006
- **Last updated:** 09/11/2025