Provider Demographics
NPI:1245205434
Name:EPPS, JESSE MILLER III (MD)
Entity Type:Individual
Prefix:DR
First Name:JESSE
Middle Name:MILLER
Last Name:EPPS
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:112 S BRAGG AVE
Mailing Address - Street 2:
Mailing Address - City:LOOKOUT MOUNTAIN
Mailing Address - State:TN
Mailing Address - Zip Code:37350-1402
Mailing Address - Country:US
Mailing Address - Phone:423-710-5219
Mailing Address - Fax:
Practice Address - Street 1:2341 MCCALLIE AVE
Practice Address - Street 2:SUITE 402
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-3239
Practice Address - Country:US
Practice Address - Phone:423-698-3309
Practice Address - Fax:423-624-6355
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2023-04-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GAMD53696207L00000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00074363OtherRAILROAD MEDICARE
TN4346972OtherBC BS OF TN
TN4068219OtherBCBS
TN3888748Medicaid
TN3888748Medicare PIN
TN103I058873Medicare UPIN
TN3888748Medicaid