Jernigan, Thomas W
Jernigan, Thomas W is an individual health care provider with primary practice located at 325 N State Of Franklin Rd 1St Floor, Johnson City TN 37604-6062. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / Gynecology. Allopathic & Osteopathic Physicians / Gynecology is his primary health care specialty. Jernigan, Thomas W can be contacted via phone (423) 439-7272.Contact Information
Primary practice address
325 N State Of Franklin Rd 1St Floor
Johnson City TN 37604-6062
Phone: (423) 439-7272
Fax: (423) 439-7235
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | 11979 | Tennessee |
Allopathic & Osteopathic Physicians / Gynecology | 207VG0400X | 11979 | Tennessee |
Profile Details
NPI number | 1528063245 |
---|---|
LBN Legal business name | Jernigan, Thomas W |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 17th, 2005 |
Last updated | Apr 9th, 2018 - about 6 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 | 1528063245 | NPPES |
Tennessee | MEDICAID | 3169458 | |
Tennessee | Other | 3714470 |
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