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Individual

DR. CLETUS J. MCMAHON JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
90 VERMONT AVE, SUITE 300, OAK RIDGE, TN 37830-6478
(865) 481-2541
(865) 483-8151
Mailing address
90 VERMONT AVE, SUITE 300, OAK RIDGE, TN 37830-6474
(865) 481-2541
(865) 483-8151

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD9051
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
100010938
TENNCARE
TN
01
200029629
RAILROAD MEDICARE
TN
01
296033
UNITED HEALTH CARE
TN
01
3071421
BLUE CROSS BLUE SHIELD
TN
05
3168046
TN
01
4034705
AETNA
TN
Enumeration date
03/09/2006
Last updated
06/22/2017
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