Whalio Doctors

NPI 1003279662

Jake Sides

Practitioner Surgery Physician Bristol, TN

Practice location

Address
1 Medical Park Blvd STE 250w, Bristol, TN 37620-7431
Phone
(423) 844-6620
Fax
(423) 844-6626
Mailing address
1021 W Oakland Ave STE 310, Johnson City, TN 37604-2192

Registered specialties (3)

Surgery Physician Primary
Allopathic & Osteopathic Physicians Taxonomy 208600000X Licence 63286 (TN)
Surgery Physician
Allopathic & Osteopathic Physicians Taxonomy 208600000X Licence 0101275797 (VA)
Student in an Organized Health Care Education/Training Program
Student, Health Care Taxonomy 390200000X

Registry record

NPI
1003279662
Entity type
Individual
Sex (as registered)
Male
NPI issued
31 Mar 2016
Record last updated
3 Jul 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.