MEDICARE: DR. JERRY DON WALKUP 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
1	2080P0202X	Pediatric Cardiology Physician	0101256238	VA

General Provider Information

NPI Number	:	1578856985
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JERRY DON WALKUP JR. M.D.

Provider Business Mailing Address
First Line	:	2312 KNOB CREEK RD STE 208
Second Line	:
City	:	JOHNSON CITY
State	:	TN
Zip	:	37604-2367
Country	:	US
Telephone Number	:	423-610-1099
Fax Number	:

Provider Business Practice Location Address
First Line	:	2312 KNOB CREEK RD STE 208
Second Line	:
City	:	JOHNSON CITY
State	:	TN
Zip	:	37604-2367
Country	:	US
Telephone Number	:	423-610-1099
Fax Number	:	423-246-4300

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2011
Last Update Date	:	07/17/2024

Similar Medicare Providers

1376533489 — DR. ASHISH B MADHOK MD
Practice Location Address:

2312 KNOB CREEK RD , SUITE208
JOHNSON CITY, TN
37604-2367

Practice Phone: 423-610-1099
Practice Fax: 423-610-1166

1477515880 — ASHOK V MEHTA MD
Practice Location Address:

2312 KNOB CREEK RD , STE 208
JOHNSON CITY, TN
37604-2367

Practice Phone: 423-610-1099
Practice Fax: 423-610-1166

1841362555 — TRI-CITY PEDIACTRIC CARDIOLOGY P C
Practice Location Address:

2312 KNOB CREEK RD , SUITE 208
JOHNSON CITY, TN
37604-2367

Practice Phone: 423-610-1099
Practice Fax: 423-610-1166

1952667404 — TYLER DEAN STAMPER DPT
Practice Location Address:

2312 KNOB CREEK RD STE 200
JOHNSON CITY, TN
37604-2367

Practice Phone: 423-232-8302
Practice Fax: 423-794-1485

1093059172 — MS. AMANDA GAYLE PRICE DPT
Practice Location Address:

2312 KNOB CREEK RD STE 200
JOHNSON CITY, TN
37604-2367

Practice Phone: 423-232-8302
Practice Fax: 423-794-1485

1508296112 — AGILITAS USA, INC.
Practice Location Address:

2312 KNOB CREEK RD STE 200
JOHNSON CITY, TN
37604-2367

Practice Phone: 423-232-8302
Practice Fax: 423-794-1485

Directions to “ DR. JERRY DON WALKUP JR. M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.