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Individual

DR. JASON GLEN FUNDERBURK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
116 CONCORD RD, SUITE 500, KNOXVILLE, TN 37934-2940
(865) 777-6880
Mailing address
116 CONCORD RD, SUITE 500, KNOXVILLE, TN 37934-2940
(865) 777-6880

Taxonomy

Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
4301102162
MI
2085R0204X
Vascular & Interventional Radiology Physician
Primary
47153
TN
2085R0204X
Vascular & Interventional Radiology Physician
ME 93065
FL

Other

Enumeration date
04/27/2006
Last updated
04/09/2014
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