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Individual

DR. PAUL A MIRANDA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1000 TN-28, JASPER, TN 37347
(423) 837-3400
Mailing address
2589 BRISTLECONE LN, SIGNAL MOUNTAIN, TN 37377-1473
(423) 243-8196

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
MD034164
TN
207Q00000X
Family Medicine Physician
Primary
34164
TN
207Q00000X
Family Medicine Physician
70270
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1508291
TN
01
4352656
BCBS - TENNESSEE
TN
Enumeration date
07/13/2006
Last updated
05/15/2024
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