Provider Demographics
NPI:1427000462
Name:MEYERS, TONY L (MD)
Entity type:Individual
Prefix:DR
First Name:TONY
Middle Name:L
Last Name:MEYERS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:200 FORT SANDERS WEST BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-3357
Mailing Address - Country:US
Mailing Address - Phone:865-342-5811
Mailing Address - Fax:865-342-5857
Practice Address - Street 1:200 FORT SANDERS WEST BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-3357
Practice Address - Country:US
Practice Address - Phone:865-342-5811
Practice Address - Fax:865-342-5857
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN10914207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4034713OtherAETNA
TN3376258Medicaid
TN0047934OtherBLUE CROSS
TN4034713OtherAETNA
TNB03652Medicare UPIN