Provider Demographics
NPI:1871588806
Name:JONES, PHILLIP WAYNE (MD)
Entity type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:WAYNE
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6701 BAUM DR
Mailing Address - Street 2:SUITE 140
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-7360
Mailing Address - Country:US
Mailing Address - Phone:865-584-5727
Mailing Address - Fax:865-450-9904
Practice Address - Street 1:2428 KNOB CREEK RD
Practice Address - Street 2:SUITE 102
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-2101
Practice Address - Country:US
Practice Address - Phone:423-794-1074
Practice Address - Fax:423-794-1079
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2018-02-08
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Provider Licenses
StateLicense IDTaxonomies
TNMD34525207RP1001X, 207K00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3384817Medicaid