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Individual

DR. JERRY JAGGERS EMBRY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
7632 GLEASON DR, KNOXVILLE, TN 37919-6818
(865) 470-2719
(865) 694-4784
Mailing address
7632 GLEASON DR, KNOXVILLE, TN 37919-6818
(865) 470-2719
(865) 694-4784

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD0000006080
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2004724
BCBS OF TENN. PIN #
TN
05
3145120
TN
01
3305434
AETNA PROVIDER NUMBER
01
NN0066727
UNITED BEHAVIORAL HEALTH
Enumeration date
02/24/2007
Last updated
07/08/2007
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