Individual
TRACEY D BEVERLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
321 TELLICO STREET, MADISONVILLE, TN 37354-1194
(865) 213-8594
(865) 213-8359
Mailing address
304 WRIGHT STREET, SWEETWATER, TN 37874-2823
(865) 213-8336
(865) 213-8359
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD37666
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4330111
BLUE CROSS BLUE SHIELD
TN
05
—
Q000340
—
TN
Enumeration date
06/01/2006
Last updated
12/02/2013
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