Individual
DR. JEFFREY FUQUA
Active
Individual
DR. JEFFREY FUQUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
21684
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050083455
TRAVELERS MEDICARE
TN
01
—
100034882
PHP TENNCARE
TN
05
—
3863961
—
TN
01
—
4020664
BLUE CROSS
TN
Enumeration date
03/09/2006
Last updated
06/16/2010
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