Jaquith, Bradley Peterson

Jaquith, Bradley Peterson is an individual health care provider with primary practice located at 1819 Clinch Ave Ste 100 , Knoxville TN 37916-2435. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Jaquith, Bradley Peterson can be contacted via phone (865) 524-5365.

Contact Information

Primary practice address
1819 Clinch Ave Ste 100 Knoxville TN 37916-2435
Phone: (865) 524-5365
Fax: (865) 524-5047
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 54212 Tennessee
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 54212 Tennessee

Profile Details

NPI number 1336448588
LBN Legal business name Jaquith, Bradley Peterson
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 26th, 2011
Last updated Oct 13th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336448588 NPPES
Tennessee MEDICAID Q024105

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