Healthcare Provider Details

I. General information

NPI: 1295661189
Provider Name (Legal Business Name): JONATHAN LEE SAWYERS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 N MAIN ST
CLINTON TN
37716-3027
US

IV. Provider business mailing address

215 FLORIDA STREET APT 1419
KNOXVILLE TN
37915
US

V. Phone/Fax

Practice location:
  • Phone: 865-457-8636
  • Fax:
Mailing address:
  • Phone: 304-222-3622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number13223
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: