Healthcare Provider Details

I. General information

NPI: 1124481775
Provider Name (Legal Business Name): SARAH JENKINS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2016
Last Update Date: 04/11/2022
Certification Date: 04/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1926 ALCOA HWY STE 410
KNOXVILLE TN
37920-1545
US

IV. Provider business mailing address

PO BOX 415000-MSC8129
NASHVILLE TN
37241-8129
US

V. Phone/Fax

Practice location:
  • Phone: 653-058-7808
  • Fax: 865-305-8199
Mailing address:
  • Phone: 865-670-6199
  • Fax: 865-670-6198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number64955
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: