Provider Demographics
NPI:1467896365
Name:GENTRY, JIMMY D II (MD)
Entity type:Individual
Prefix:
First Name:JIMMY
Middle Name:D
Last Name:GENTRY
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:6311 KINGSTON PIKE STE 26W
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-4900
Mailing Address - Country:US
Mailing Address - Phone:865-674-9193
Mailing Address - Fax:865-409-5688
Practice Address - Street 1:6311 KINGSTON PIKE STE 26W
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-4900
Practice Address - Country:US
Practice Address - Phone:865-674-9193
Practice Address - Fax:865-409-5688
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-22
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN62109207RN0300X
KY49203208M00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist