Individual
PAUL L JETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2205 PAVILION DR STE 201, KINGSPORT, TN 37660-4614
(423) 392-6000
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 302-6565
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
0101272721
VA
208100000X
Physical Medicine & Rehabilitation Physician
MD39397
TN
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
0101272721
VA
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
MD39397
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1509475
—
TN
05
—
3332616
—
TN
Enumeration date
05/11/2006
Last updated
03/21/2023
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