Individual
THOMAS W JERNIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
325 N STATE OF FRANKLIN RD, 1ST FLOOR, JOHNSON CITY, TN 37604-6062
(423) 439-7272
(423) 439-7235
Mailing address
325 N STATE OF FRANKLIN RD, 1ST FLOOR, JOHNSON CITY, TN 37604-6062
(423) 439-7272
(423) 439-7235
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
11979
TN
207VG0400X
Gynecology Physician
Primary
11979
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3169458
—
TN
01
—
3714470
GROUP MEDICARE NUMBER
TN
Enumeration date
06/17/2005
Last updated
04/09/2018
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