Individual
DR. ROBERT MICKEY MAUGHON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1015 EAST PARKWAY, GATLINBURG, TN 37738-1015
(865) 436-7267
(865) 430-4179
Mailing address
PO BOX 1518, PIGWON FORGE, TN 37868-1518
(865) 365-1510
(865) 365-1610
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD16795
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100010733
—
TN
05
—
3023149
—
TN
01
—
57934
BLUE CROSS BLUE SHIELD
TN
Enumeration date
10/03/2006
Last updated
03/03/2011
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