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General NPI Number Information
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NPI Number | 1124096136
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Entity Type | Individual
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Provider Name | JESSICA IVEY MD
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Gender | Female
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Dates
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Enumeration Date | 03/08/2006
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Last Update Date | 06/29/2023
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Provider Practice Location Address
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Address Line | 9333 PARK WEST BLVD STE 200
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City | KNOXVILLE
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State | TN
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Zip | 37923-4317
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Country | US
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Telephone | 865-531-4600
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Fax | 833-908-2096
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Provider Business Mailing Address
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Address Line | PO BOX 26194
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City | BELFAST
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State | ME
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Zip | 04915-2012
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Country | US
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Telephone | 865-584-4747
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Fax | 865-450-3172
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | 034822
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 34822
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License Number State | TN
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