Unknown Individual – Obstetrics & Gynecology Physician, NPI 1043240658

Unknown Individual is a healthcare provider. based in Athens, Tennessee. specializing in Obstetrics & Gynecology Physician. They hold a License No. 0022088 (TN). The NPI Number for Unknown Individual is 1043240658

Main info

Organization
Inactive
42 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1043240658
Phone
(423) 507-8067
Address
PO BOX 769
Deactivation Date
23 August 2021

Doctor Profile

Medical School Name
MEDICAL UNIVERSITY OF SOUTH CAROLINA COLLEGE OF MEDICINE
Secondary Phone
6207928833
Graduation Year
1984 (42 years ago)
PAC ID
7618145590
Group Practice PAC ID
5597016378
Professional Enrollment ID
I20200128002045
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Box, 4, Κωλέττη, Exarcheia, Athens, Municipality of Athens, Regional Unit of Central Athens, Attica, 106 81, Greece

    135 N MEADOWS DRIVE SUITE B

    ATHENS, TN 373710769

    Phone: (423) 507-8067

    Fax: (423) 746-1805

    Type: Mailing

  • 135, North Meadows Drive, Bohannon Addition, Athens, McMinn County, East Tennessee, Tennessee, 37303, United States

    SUITE B

    ATHENS, TN 37303

    Phone: (423) 507-8067

    Fax: (423) 746-1805

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 37371)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5597016378View full group profile
NameSpecialtyState
Family PracticeKS
Physician AssistantKS
O B S T E T R I C S/ G Y N E C O L O G YKS
Nurse PractitionerKS
Nurse PractitionerKS
Physical Therapist In Private PracticeKS
-MS
Nurse PractitionerKS
Emergency Medicine, Family PracticeKS
Nurse PractitionerKS

Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?
The federal identifier for Unknown Individual is NPI 1043240658.
How do I interpret inactive records for Unknown Individual?
Treat inactive as a signal to verify Unknown Individual through official channels.
What kind of provider is Unknown Individual?
The page reflects Obstetrics & Gynecology Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual's primary listing?
We display Athens, Tennessee because that is what the record indicates for Unknown Individual.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1043240658. Always confirm identity and privileges with the practice and licensing boards.

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