Individual provider · NPI-1

Brian Blake Childress, PA

Physician Assistant · Jackson, TN

NPI number1740791847
StatusActive
Last updated in NPPESApr 3, 2026

Details

NPI
1740791847
Entity type
Individual (NPI-1)
Name
Brian Blake Childress
Credential
PA
Sex
Male
Sole proprietor
No
Enumeration date
Oct 16, 2017
Certification date
Apr 3, 2026
Last updated
Apr 3, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363A00000X Physician AssistantPA3467TNYes

Practice location

87 Murray Guard Dr Ste B
Jackson, TN 38305-3775

Phone 731-422-0213 · Fax 731-660-8319

Mailing address

Po Box 400
Jackson, TN 38302-0400

Phone 731-422-0213 · Fax 731-660-8319

Other practice locations

1450 Dowell Springs Blvd Ste 210
Knoxville, TN 37909-2448

Phone 865-524-2547

1928 Alcoa Hwy Ste 209
Knoxville, TN 37920-1504

Phone 865-524-2547

133 Associates Blvd
Alcoa, TN 37701-1944

Phone 865-233-7351

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