Individual
JOHN WAYNE MCMICHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6108 KINGSTON PIKE, KNOXVILLE, TN 37919-4019
(865) 539-9299
(865) 539-9701
Mailing address
109 COUNTY ROAD 1150, RICEVILLE, TN 37370-5795
(423) 525-7120
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25941
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1507230
—
TN
01
—
4185180
BCBSTN THRU APPALACHIAN MED SVCS
TN
01
—
P00643329
RAILROAD MEDICARE
TN
Enumeration date
05/24/2006
Last updated
05/10/2017
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