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Individual

NORMAN E LIDDELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD, PHD

Contact information

Practice address
1240 FOX MEADOWS BOULEVARD, SUITE 6, SEVIERVILLE, TN 37862-6928
(865) 428-4042
(865) 428-8191
Mailing address
1240 FOX MEADOWS BOULEVARD, SUITE 6, SEVIERVILLE, TN 37862-6928
(865) 428-4042
(865) 428-8191

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD28522
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10012098
PHP TENNCARE
TN
01
1578547758
HUMANA
TN
05
38043801
TN
01
3940202
UNITED HEALTHCARE
TN
01
4024131
BCBS
TN
01
4472010
AETNA
TN
01
702002822
CARITEN
TN
01
8710353
CIGNA
TN
Enumeration date
12/01/2005
Last updated
07/06/2010
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