Healthcare Provider Details

I. General information

NPI: 1396058574
Provider Name (Legal Business Name): JONATHAN BEN LAYMANCE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2010
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1825 KNOXVILLE HWY
WARTBURG TN
37887-4120
US

IV. Provider business mailing address

1275 DICK LONAS RD
KNOXVILLE TN
37909-1382
US

V. Phone/Fax

Practice location:
  • Phone: 423-346-3600
  • Fax: 833-908-2181
Mailing address:
  • Phone: 865-584-4747
  • Fax: 865-381-1509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number48301
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: