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General NPI Number Information
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NPI Number | 1427184696
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Entity Type | Individual
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Provider Name | JERRY JAGGERS EMBRY M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/24/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7632 GLEASON DR
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City | KNOXVILLE
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State | TN
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Zip | 37919-6818
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Country | US
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Telephone | 865-470-2719
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Fax | 865-694-4784
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Provider Business Mailing Address
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Address Line | 7632 GLEASON DR
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City | KNOXVILLE
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State | TN
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Zip | 37919-6818
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Country | US
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Telephone | 865-470-2719
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Fax | 865-694-4784
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD0000006080
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License Number State | TN
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