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NPI Code Detail

MEDICARE: DR. GLENN EDWARD JEFFRIES JR. M.D.

MEDICARE: DR. GLENN EDWARD JEFFRIES JR. M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery PhysicianMD9044TN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
6200029548OTHERTNRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1100020847OTHERTNTENNCARE
24537213OTHERTNAETNA
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4TN0109OTHERTNJOHN DEERE HEALTHCARE
5TN0110OTHERTNJOHN DEERE HEALTHCARE
7TN0178OTHERTNJOHN DEERE HEALTHCARE
80940100OTHERTNUNITED HEALTH CARE
93071399OTHERTNBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1518934991
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GLENN EDWARD JEFFRIES JR. M.D.
Provider Business Mailing Address
First Line : 1926 ALCOA HWY
Second Line : BLDG. F, SUITE 210
City : KNOXVILLE
State : TN
Zip : 37920-1545
Country : US
Telephone Number : 865-546-2663
Fax Number : 865-546-9047
Provider Business Practice Location Address
First Line : 1926 ALCOA HWY
Second Line : BLDG. F, SUITE 210
City : KNOXVILLE
State : TN
Zip : 37920-1545
Country : US
Telephone Number : 865-546-2663
Fax Number : 865-546-9047
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2006
Last Update Date : 10/25/2013

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