Provider Demographics
NPI:1972868438
Name:SALYARDS, JILL (DO)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:SALYARDS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 CAPITAL DR STE 202
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-3581
Mailing Address - Country:US
Mailing Address - Phone:865-545-0900
Mailing Address - Fax:
Practice Address - Street 1:161 CAPITAL DR STE 202
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-3581
Practice Address - Country:US
Practice Address - Phone:865-545-0900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-11
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4155207N00000X
FLOS13888207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty