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Individual

STEPHEN MICHAEL TEAGUE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
919 E CENTRAL AVE STE 102, LA FOLLETTE, TN 37766-2778
(423) 907-1740
(423) 907-1743
Mailing address
919 E CENTRAL AVE STE 102, LA FOLLETTE, TN 37766-2778
(423) 907-1740
(423) 907-1743

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD33973
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
060057805
RAILROAD MEDICARE
TN
05
1523025
TN
Enumeration date
05/24/2006
Last updated
09/10/2020
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