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Individual

JASON J DELLA VECCHIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1700 PINEBROOK DR STE 4, KINGSPORT, TN 37660-4365
(423) 251-6670
(423) 251-1899
Mailing address
5 GARDEN WAY, JOHNSON CITY, TN 37604-6086
(423) 483-7701
(423) 431-1811

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
200400663
NC
207R00000X
Internal Medicine Physician
31318
SC
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
47972
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1362H
BCBS
NC
05
1527494
TN
05
1770554982
VA
05
7100194900
KY
05
891362H
NC
01
P00213994
RAILROAD MEDICARE
NC
Enumeration date
01/27/2006
Last updated
05/30/2025
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