Organization
SOUTHWELL MEDICAL LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAKE HARRISON FNP (OWNER)
(865) 455-4817
Entity
Organization
Contact information
Practice address
207 LAKE FOREST DR, KNOXVILLE, TN 37920-5144
(865) 455-4817
Mailing address
207 LAKE FOREST DR, KNOXVILLE, TN 37920-5144
(865) 455-4817
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
—
—
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/05/2023
Last updated
01/05/2023
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