Individual
JAMIE KENDALL BARTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2000 BROOKSIDE DR, 3RD FLOOR, KINGSPORT, TN 37660-4627
(423) 857-5905
(423) 857-5904
Mailing address
509 MED TECH PKWY STE 100, JOHNSON CITY, TN 37604-2579
(423) 302-6565
(423) 952-2175
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
1677
TN
208M00000X
Hospitalist Physician
02972
KY
208M00000X
Hospitalist Physician
1677
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386679462
—
NC
05
—
1386679462
—
VA
05
—
7100008420
—
KY
01
—
P01706861
RAILROAD MEDICARE
TN
05
—
Q020423
—
TN
Enumeration date
07/11/2006
Last updated
06/06/2022
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