Individual
DR. JULIE W JETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1924 ALCOA HWY # U67, KNOXVILLE, TN 37920-1511
(865) 305-9350
(865) 305-8681
Mailing address
1924 ALCOA HWY # U67, KNOXVILLE, TN 37920-1511
(865) 305-9350
(865) 305-8681
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
29613
TN
207Q00000X
Family Medicine Physician
Primary
29613
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1510993
—
TN
01
—
1689631137
GROUP NPI
TN
01
—
3373352
MEDICAID GROUP
TN
01
—
3373352
MEDICARE GROUP
—
Enumeration date
11/30/2006
Last updated
09/28/2012
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