Individual
DR. RONALD JC FEJERAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1442 N BROAD ST, SUITE 7, TAZEWELL, TN 37879-4361
(423) 626-1931
(423) 626-1948
Mailing address
PO BOX 959, ATTN: CREDENTIALING, NEW TAZEWELL, TN 37824-0959
(423) 626-1931
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0999
TN
208000000X
Pediatrics Physician
999
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1506800
—
TN
05
—
3303563
—
TN
Enumeration date
06/15/2005
Last updated
01/07/2020
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