Individual
PERRY JERNIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1301 SUNSET DR, STE 3, JOHNSON CITY, TN 37604-7906
(423) 926-4966
(423) 926-1823
Mailing address
1301 SUNSET DR, STE 3, JOHNSON CITY, TN 37604-7906
(423) 926-4966
(423) 926-1823
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
0101259949
VA
2085R0202X
Diagnostic Radiology Physician
Primary
30603
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100022659
PHP TNCARE
TN
01
—
300086799
RAILROAD MEDICARE
TN
01
—
3098340
BCBS
TN
05
—
3828412
—
TN
01
—
64305642
KENTUCKY MEDICAID
KY
01
—
7222688
VIRGINIA MEDICAID
VI
01
—
89063JH
NORTH CAROLINA MEDICAID
NC
Enumeration date
05/15/2006
Last updated
04/29/2025
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