Provider Demographics
NPI:1588612907
Name:PARHAM, JON SIMPSON (DO, MPH)
Entity Type:Individual
Prefix:
First Name:JON
Middle Name:SIMPSON
Last Name:PARHAM
Suffix:
Gender:M
Credentials:DO, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1924 ALCOA HWY
Mailing Address - Street 2:U-67
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1511
Mailing Address - Country:US
Mailing Address - Phone:865-544-9352
Mailing Address - Fax:865-544-9314
Practice Address - Street 1:1924 ALCOA HWY
Practice Address - Street 2:U-110
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1511
Practice Address - Country:US
Practice Address - Phone:865-544-9351
Practice Address - Fax:865-544-9314
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDO534207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNTN01G3OtherJOHN DEERE
TN3049827OtherBLUE CROSS/BLUE SHIELD
TN3304482Medicaid
TN3304484OtherAETNA
TN1689631137OtherGROUP NPI
TN01-41253OtherUNITED HEALTH CARE
TN100011026OtherPHP TENNCARE
TN595988OtherCIGNA
TN1689631137OtherGROUP NPI
TN3304484OtherAETNA
080120659Medicare ID - Type UnspecifiedRAILROAD MEDICARE