Provider Demographics
NPI:1326083015
Name:WARRICK, JAY HENDERSON (MD)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:HENDERSON
Last Name:WARRICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4707 PAPERMILL DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-1900
Mailing Address - Country:US
Mailing Address - Phone:865-602-7983
Mailing Address - Fax:865-602-7984
Practice Address - Street 1:4707 PAPERMILL DR
Practice Address - Street 2:SUITE 200
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-1900
Practice Address - Country:US
Practice Address - Phone:865-602-7983
Practice Address - Fax:865-602-7984
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-18
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN21334207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNE82567Medicare UPIN
3059302Medicare ID - Type Unspecified