Jaquith, Bradley Peterson
Jaquith, Bradley Peterson is an individual health care provider with primary practice located at 1819 Clinch Ave Ste 100 , Knoxville TN 37916-2435. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Jaquith, Bradley Peterson can be contacted via phone (865) 524-5365.Contact Information
Primary practice address
1819 Clinch Ave Ste 100
Knoxville TN 37916-2435
Phone: (865) 524-5365
Fax: (865) 524-5047
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 54212 | Tennessee |
Allopathic & Osteopathic Physicians / Sports Medicine | 207XX0005X | 54212 | Tennessee |
Profile Details
NPI number | 1336448588 |
---|---|
LBN Legal business name | Jaquith, Bradley Peterson |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Mar 26th, 2011 |
Last updated | Oct 13th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1336448588 | NPPES |
Tennessee | MEDICAID | Q024105 |
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