Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD33930 | TN |
N | 2080P0204X | Pediatric Emergency Doctor | MD33930 | TN |
NPI | 1053348458 |
---|---|
Provider Name | Dr. Billy Paul Jones |
First Address | Knoxville, TN 37919-7194 |
Second Address | Knoxville, TN 37916-2301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3899380 | (05) | TN |
4016639 | BLUE CROSS (01) | TN |
64037161 | (05) | KY |