Provider Demographics
NPI:1811421555
Name:FUERST, JONATHAN SAMUEL (MD)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:SAMUEL
Last Name:FUERST
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 1:9050 EXECUTIVE PARK DR STE 202A
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4670
Mailing Address - Country:US
Mailing Address - Phone:423-305-6017
Mailing Address - Fax:
Practice Address - Street 1:1124 E WEISGARBER RD STE 207
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-2686
Practice Address - Country:US
Practice Address - Phone:865-588-0811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-19
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN67752207W00000X, 207WX0107X
AL37223207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology