Healthcare Provider Details

I. General information

NPI: 1588612907
Provider Name (Legal Business Name): JON SIMPSON PARHAM DO, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 09/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1924 ALCOA HWY U-110
KNOXVILLE TN
37920-1511
US

IV. Provider business mailing address

1924 ALCOA HWY U-67
KNOXVILLE TN
37920-1511
US

V. Phone/Fax

Practice location:
  • Phone: 865-544-9351
  • Fax: 865-544-9314
Mailing address:
  • Phone: 865-544-9352
  • Fax: 865-544-9314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO534
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: