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Individual

ROGER DALE GADDIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
266 JOULE ST, ALCOA, TN 37701-2422
(865) 984-3864
(865) 380-4095
Mailing address
701 MORGANTON SQUARE DR, MARYVILLE, TN 37801-4796
(865) 273-1752
(865) 273-1755

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO0000001730
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1513698
TN
05
4334952
TN
Enumeration date
06/08/2007
Last updated
01/13/2015
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