Individual
JACOB APPLEGATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
9320 PARK WEST BLVD, KNOXVILLE, TN 37923-4301
(865) 373-7100
Mailing address
9320 PARK WEST BLVD, KNOXVILLE, TN 37923-4301
(865) 373-1700
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AS0400X
Surgical Physician Assistant
6406
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q099989
—
TN
Enumeration date
10/28/2024
Last updated
03/06/2025
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