Provider Demographics
NPI:1396826368
Name:YOUNG, JAY ALGER (MD)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:ALGER
Last Name:YOUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10810 PARKSIDE DR STE 201
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-1983
Mailing Address - Country:US
Mailing Address - Phone:865-392-9220
Mailing Address - Fax:865-392-9221
Practice Address - Street 1:10810 PARKSIDE DR STE 201
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-1983
Practice Address - Country:US
Practice Address - Phone:865-392-9220
Practice Address - Fax:865-392-9221
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD028179208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3803240Medicaid
TN3041992OtherBLUE CROSS
TNF05624Medicare UPIN
TN3803240Medicare ID - Type Unspecified