Jesse E Von Fange, PA-C Valid NPI

Individual provider · Medical Physician Assistant · Knoxville, TN

NPI

1265996672

Type

Individual (Type 1)

Primary specialty

Medical Physician Assistant (Physician Assistant)

Specialty group

Physician Assistants & Advanced Practice Nursing Providers

Taxonomy code

363AM0700X

License number

3804 (TN)

Sex

Male

Sole proprietor

No

Enumerated

2019-01-30

Last updated

2020-03-04