Healthcare Provider Details

I. General information

NPI: 1255376513
Provider Name (Legal Business Name): DAVID JERDEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2006
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6600 NIGHTINGALE LN
KNOXVILLE TN
37909-2754
US

IV. Provider business mailing address

6600 NIGHTINGALE LN
KNOXVILLE TN
37909-2754
US

V. Phone/Fax

Practice location:
  • Phone: 865-632-5885
  • Fax: 865-374-2164
Mailing address:
  • Phone: 865-632-5885
  • Fax: 865-374-2164

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number32212
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: