Healthcare Provider Details

I. General information

NPI: 1821130691
Provider Name (Legal Business Name): JEFFERY VAUGHAN ATKINS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ERLANGER BLEDSOE COUNTY HOSPITAL 128 WHEELER ROAD
PIKEVILLE TN
37367
US

IV. Provider business mailing address

3120 WATERFRONT DR
CHATTANOOGA TN
37419-1535
US

V. Phone/Fax

Practice location:
  • Phone: 423-447-2112
  • Fax:
Mailing address:
  • Phone: 423-821-0018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD0000014114
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: