Most Relevant Information
Provider Data
| NPI Number: | 1003279662 |
| Provider Name: | JAKE SIDES |
| Entity Type: | Individual |
| Taxonomy Code: | 208600000X |
| Specialty: | Surgery |
| License Number: | 0101275797 |
Most Important Dates
| Enumeration Date: | 03/31/2016 |
| Last Updated: | 07/03/2024 |
Provider Practice Location
1 MEDICAL PARK BLVD STE 250W
BRISTOL
TN
376207431
Practice Location Phone/Fax
| Phone: | 4238446620 |
| Fax: | 4238446626 |
Provider Mailing Location
1021 W OAKLAND AVE STE 310
JOHNSON CITY
TN
376042192
Provider Mailing Phone/Fax
| Phone: | 4233026565 |
| Fax: |
Suggested EMR
Surgeon EMR