Provider Demographics
NPI:1922075001
Name:JEMISON, DAVID MARSHALL (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MARSHALL
Last Name:JEMISON
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 1:979 E 3RD ST
Mailing Address - Street 2:SUITE C920
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-2136
Mailing Address - Country:US
Mailing Address - Phone:423-756-7134
Mailing Address - Fax:423-763-4571
Practice Address - Street 1:979 E 3RD ST
Practice Address - Street 2:SUITE C920
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-2136
Practice Address - Country:US
Practice Address - Phone:423-756-7134
Practice Address - Fax:423-763-4571
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN15654207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA04051010007OtherPALMETTO DME
GA0900973OtherUHC INSURANCE
TN1114640001OtherPALMETTO DME
TN0900517OtherUHC INSURANCE
GAGA0106OtherJOHN DEERE INSURANCE
TN2007378OtherBCBS INSURANCE
TNTN0108OtherJOHN DEERE INSURANCE
TN2006636OtherBCBS GROUP
TNPLF03906636OtherCHAMPUS INSURANCE
TN00458433AMedicaid
GA0900973OtherUHC INSURANCE
TN00458433AMedicaid
TN0900517OtherUHC INSURANCE