Provider Demographics
NPI:1548225030
Name:INGLEBY, JEFFREY P (DC)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:P
Last Name:INGLEBY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10841 KINGSTON PIKE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-3054
Mailing Address - Country:US
Mailing Address - Phone:865-675-7070
Mailing Address - Fax:865-671-1321
Practice Address - Street 1:10841 KINGSTON PIKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-3054
Practice Address - Country:US
Practice Address - Phone:865-675-7070
Practice Address - Fax:865-671-1321
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN492111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
4440012OtherUNITEDHEALTHCARE
DC492OtherCARITEN
TN36741741Medicaid
4106054OtherCIGNA
4488478OtherAETNA
4106054OtherCIGNA
DC492OtherCARITEN