Provider Demographics
NPI:1699744854
Name:MCGRAW, JOHN JAY SR (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JAY
Last Name:MCGRAW
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:260 FORT SANDERS WEST BLVD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-3355
Mailing Address - Country:US
Mailing Address - Phone:865-769-4545
Mailing Address - Fax:865-769-4501
Practice Address - Street 1:120 HOSPITAL DR
Practice Address - Street 2:SUITE 250
Practice Address - City:JEFFERSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37760-5287
Practice Address - Country:US
Practice Address - Phone:865-558-4400
Practice Address - Fax:865-475-1124
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD37671207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4066070OtherBLUE CROSS BLUE SHIELD
TNTN01G9OtherJOHN DEERE HEALTHCARE
TN3886924Medicaid
TNP00128075OtherRAILROAD MEDICARE
TN1512309Medicaid
TN3886924Medicaid
TN3886924Medicare PIN
A13342Medicare UPIN
TN3711676Medicare PIN
TN103I208260Medicare PIN