Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Jack Claudious Justice III, PA-C

Individual provider Physician Assistant · NPI 1871180117

Mr. Jack Claudious Justice III, PA-C is a Physician Assistant in Johnson City, Tennessee. Licensed in Tennessee. Registered with an NPI since 2020.

Licensed in
TN
In the registry since
2020
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

2244 Boones Creek Rd
Johnson City, TN 37615-4432
Phone: (423) 782-0243
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 4367 (TN)

Record details

NPI number1871180117
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedDecember 21, 2020
Last updated in NPPESDecember 23, 2020
Certification dateDecember 23, 2020

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