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Individual

DR. JAN ALLEN DEWITT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
109 LAND OAK RD, KNOXVILLE, TN 37922-2011
(865) 777-1300
Mailing address
314 QUAIL DR, JOHNSON CITY, TN 37601-2038

Taxonomy

Speciality
Code
Description
License number
State
146D00000X
Personal Emergency Response Attendant
21904
WV
174400000X
Specialist
21904
WV
207P00000X
Emergency Medicine Physician
Primary
33357
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
64039050
KY
Enumeration date
07/04/2006
Last updated
12/14/2009
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