Fraser G Tudiver, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

36003 Issued in TN

Practice address

917 W Walnut St
Johnson City, TN 37604-6527

Phone

(423) 439-6464

Fax

(423) 439-7118

NPI assigned

Dec 22, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289174400000",
    "number": "1386620169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 699",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "37684",
            "telephone_number": "423-439-6464",
            "fax_number": "423-439-7118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 W WALNUT ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046527",
            "telephone_number": "423-439-6464",
            "fax_number": "423-439-7118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUDIVER",
        "first_name": "FRASER",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2010-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "36003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas A Truman, PA-C
• Trusted Benefits
• Joseph T Tucciarone Jr., PSYCHOLOGY INTERN
• Melissa Renee Tucker, LPC-MHSP, NCC
• William D. Tucker, MD
• Judith G Tudiver, PH.D.
• Dawn S Tuell, MD
• Laura Dawn Tugman, PHD
• Bailey Lynn Tullis, FNP
• Sheena L Tullock, FNP

• Family Medicine Physician in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.