Provider Demographics
NPI:1972534295
Name:ROTHWELL, JOSEPH MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:MICHAEL
Last Name:ROTHWELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:744 MIDDLE CREEK RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:SEVIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37862
Mailing Address - Country:US
Mailing Address - Phone:865-446-9700
Mailing Address - Fax:865-446-9707
Practice Address - Street 1:744 MIDDLE CREEK RD
Practice Address - Street 2:SUITE 208
Practice Address - City:SEVIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37862
Practice Address - Country:US
Practice Address - Phone:865-446-9700
Practice Address - Fax:865-446-9707
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN24963208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3079230Medicaid