Basic Information
| Provider Information | |||||||||
| NPI: | 1386937415 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HADDIX | ||||||||
| FirstName: | MELISSA | ||||||||
| MiddleName: | DUNAWAY | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1431 CENTERPOINT BLVD STE 100 | ||||||||
| Address2: | |||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379321983 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6064391559 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1 TRILLIUM WAY | ||||||||
| Address2: | |||||||||
| City: | CORBIN | ||||||||
| State: | KY | ||||||||
| PostalCode: | 407018727 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6065281212 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2011 | ||||||||
| LastUpdateDate: | 03/23/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/23/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 03606 | KY | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207Q00000X | R2757 | KY | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.