Provider Demographics
NPI:1467462150
Name:JUMP, JEFFREY S (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:S
Last Name:JUMP
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 1:320 EAST MAIN STREET
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37408
Mailing Address - Country:US
Mailing Address - Phone:423-643-2246
Mailing Address - Fax:423-643-2030
Practice Address - Street 1:320 EAST MAIN STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37408
Practice Address - Country:US
Practice Address - Phone:423-643-2246
Practice Address - Fax:423-643-2030
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD28299207Q00000X
TN28299207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4024515OtherBLUE CROSS PROVIDER #
TN4024515OtherBLUE CROSS PROVIDER #
TN3807968Medicare ID - Type Unspecified