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NPI Code Detail

MEDICARE: JEREMY JAMES MUSICK

MEDICARE: JEREMY JAMES MUSICK
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
1103TC0700XClinical Psychologist4057TN

General Provider Information

NPI Number : 1871723437
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEREMY JAMES MUSICK
Provider Business Mailing Address
First Line : 6000 WALDEN DR STE 102
Second Line :
City : KNOXVILLE
State : TN
Zip : 37919-6364
Country : US
Telephone Number : 865-968-9416
Fax Number :
Provider Business Practice Location Address
First Line : 6000 WALDEN DR STE 102
Second Line :
City : KNOXVILLE
State : TN
Zip : 37919-6364
Country : US
Telephone Number : 865-968-9416
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2009
Last Update Date : 12/11/2025

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