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Individual

DR. JERICHO P BORJA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1812 SAINT ANSELM LN, KNOXVILLE, TN 37922-8565
(865) 766-5260
Mailing address
1812 SAINT ANSELM LN, KNOXVILLE, TN 37922-8565
(865) 766-5260
(865) 766-5260

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD0000038752
TN
207Q00000X
Family Medicine Physician
38752
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
156565
BETTER HEALTH
TN
01
32312
TLC
TN
05
3897760
TN
01
4091992
BLUE CROSS BLUE SHIELD
TN
01
610401661
HUMANA/TRICARE
TN
Enumeration date
06/08/2005
Last updated
05/30/2012
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