Healthcare Provider Details

I. General information

NPI: 1396826368
Provider Name (Legal Business Name): JAY ALGER YOUNG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 05/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10810 PARKSIDE DR STE 201
KNOXVILLE TN
37934-1983
US

IV. Provider business mailing address

10810 PARKSIDE DR STE 201
KNOXVILLE TN
37934-1983
US

V. Phone/Fax

Practice location:
  • Phone: 865-392-9220
  • Fax: 865-392-9221
Mailing address:
  • Phone: 865-392-9220
  • Fax: 865-392-9221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License NumberMD028179
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: