Individual
JOHN S. JAGGERS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
110 DUNHILL PL NW, CLEVELAND, TN 37311-3883
(423) 476-2212
(423) 476-7022
Mailing address
110 DUNHILL PL NW, CLEVELAND, TN 37311-3883
(423) 476-2212
(423) 476-7022
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
014978
TN
207RS0012X
Sleep Medicine (Internal Medicine) Physician
014978
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3021619
—
TN
01
—
3702756
MEDICARE GROUP NUMBER
TN
01
—
621482378
BLUE RDG PUL MED TX ID
TN
Enumeration date
06/08/2006
Last updated
07/18/2012
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