Individual
JEFFREY R BERGQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
266 JOULE ST, ALCOA, TN 37701-2422
(865) 984-3864
(865) 380-2131
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1351
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1511025
—
TN
Enumeration date
07/07/2006
Last updated
10/24/2025
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