Provider Demographics
NPI:1174525307
Name:FILKA, MARIANNE E (MD)
Entity type:Individual
Prefix:DR
First Name:MARIANNE
Middle Name:E
Last Name:FILKA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 HUGH GARLAND RD
Mailing Address - Street 2:
Mailing Address - City:JONESBOROUGH
Mailing Address - State:TN
Mailing Address - Zip Code:37659-6969
Mailing Address - Country:US
Mailing Address - Phone:423-483-1268
Mailing Address - Fax:
Practice Address - Street 1:3114 BROWNS MILL RD
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-1417
Practice Address - Country:US
Practice Address - Phone:423-631-0432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN18009207QA0401X
TNMD0000018009207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0100OtherUNITED HEALTHCARE RIVER V
TNQ037012Medicaid
080165964OtherRAILROAD MEDICARE
TN3162847OtherBLUE CROSS BLUE SHIELD
TN3030112Medicaid
TN3030112Medicaid
TN103I930502Medicare PIN