Sides, Jake

Sides, Jake is an sole proprietor health care provider with primary practice located at 1 Medical Park Blvd Ste 250W , Bristol TN 37620-7431. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Sides, Jake can be contacted via phone (423) 844-6620.

Contact Information

Primary practice address
1 Medical Park Blvd Ste 250W Bristol TN 37620-7431
Phone: (423) 844-6620
Fax: (423) 844-6626
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 0101275797 Virginia
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Surgery 208600000X 63286 Tennessee

Profile Details

NPI number 1003279662
LBN Legal business name Sides, Jake
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 31st, 2016
Last updated Jul 3rd, 2024 - about last year

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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