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Individual

PHILLIP A JERNIGAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
513 BROOKWOOD BLVD, SUITE 400, BIRMINGHAM, AL 35209-6862
(205) 877-9191
(205) 877-8377
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-08024
NC
363AM0700X
Medical Physician Assistant
TA-1724
AL

Other

Enumeration date
02/02/2011
Last updated
08/11/2021
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