Individual
ALFRED VAUGHN DERISE JACKSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
930 ADELL REE PARK LN, KNOXVILLE, TN 37909-2543
(865) 769-2600
Mailing address
930 ADELL REE PARK LN, KNOXVILLE, TN 37909-2543
(865) 769-2600
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
50821
TN
207Q00000X
Family Medicine Physician
Primary
50821
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/19/2010
Last updated
03/23/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us