Individual
DR. PRADUMNA S JAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9111 CROSS PARK DR STE D200, KNOXVILLE, TN 37923-4521
(865) 470-4130
(865) 694-1655
Mailing address
9111 CROSS PARK DR STE D200, KNOXVILLE, TN 37923-4521
(865) 470-4130
(865) 694-1655
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD0000026667
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
257338000
MAGELLAN
TN
05
—
3095083
—
TN
01
—
3112481
BLUECROSS BLUE SHIELD
TN
Enumeration date
08/18/2006
Last updated
02/14/2020
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