Basic Information
| Provider Information | |||||||||
| NPI: | 1003830746 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MEANS | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | TAYLOR | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 699 | ||||||||
| Address2: | |||||||||
| City: | MOUNTAIN HOME | ||||||||
| State: | TN | ||||||||
| PostalCode: | 376840699 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4234397280 | ||||||||
| FaxNumber: | 4234397314 | ||||||||
| Practice Location | |||||||||
| Address1: | 325 N STATE OF FRANKLIN RD | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | JOHNSON CITY | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4234397280 | ||||||||
| FaxNumber: | 4234397314 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2006 | ||||||||
| LastUpdateDate: | 07/30/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 38674 | KY | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RH0000X | 38674 | KY | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology | 207RH0003X | 38674 | KY | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | 207RH0000X | 16949 | TN | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology |
ID Information
| ID | Type | State | Issuer | Description | 64930423 | 05 | KY | MEDICAID | 3714470 | 01 | TN | GROUP MEDICARE NUMBER | OTHER |