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Individual

JESSE E VON FANGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
280 FORT SANDERS WEST BLVD STE 101, KNOXVILLE, TN 37922-3352
(865) 539-0270
(865) 539-6998
Mailing address
1275 DICK LONAS RD UNIT 101, KNOXVILLE, TN 37909-1383
(865) 584-4747
(865) 584-1363

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
3804
TN

Other

Enumeration date
01/30/2019
Last updated
03/04/2020
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