Jeffrey E. Hazlewood, M.D., P.C.
Organization Active NPI Physical Medicine & Rehabilitation Physician · Lebanon, TN
NPI 1699717033 · NPPES record last updated Mar 7, 2008
Key facts
- NPI
- 1699717033
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Medicine & Rehabilitation Physician 208100000X
- License
- MD0000027823 (TN)
- Legal business name
- JEFFREY E. HAZLEWOOD, M.D., P.C.
- Practice address
- 100 Physicians Way
Suite 250
Lebanon, TN 37090-8102 - Phone
- (615) 444-3307
- Fax
- (615) 444-5579
- NPI assigned
- Jun 11, 2006
- Organization subpart
- No
Authorized official
- Name
- Jeffrey E. Hazlewood, M.D.
- Title
- President
- Phone
- (615) 444-3307
Practitioners 7
-
Stacey Atkins, FNP-C
-
Susan M Harris, APN
-
Jeffrey E. Hazlewood, M.D.
-
Jenna Hazlewood, LMFT
-
Thomas Scott Baker, M.D.
-
Kimberly S Vernier, APN
-
Keith T Winfree, APRN-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060707000272 | TN | Part B Supplier - Clinic/Group Practice | 3971515156 |
Receives reassigned benefits from 3 practitioners Practice locations: Lebanon, TN |
National Provider Directory
Locations
100 Physicians Way
Ste 250
Lebanon, TN 37090
Phone (615) 444-0554
1670 W Main St
Ste 160
Lebanon, TN 37087
Phone (615) 444-0554
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician |
208100000X | MD0000027823 | TN | Yes |
Addresses
Primary practice location
100 Physicians Way
Suite 250
Lebanon, TN 37090-8102
Mailing address
PO Box 2149
Lebanon, TN 37088-2149
Phone (615) 444-3307
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4121917 | Other | TN | BCBS |
| 3733565 | Medicaid | TN |
Other providers in Lebanon, TN
- McKenzie Jackson
- Mahak Jain
- James M Bachstein, MD
- Robert Joseph Jantz
- Thomas P Jaselskis
- Claudia Jett
- Hannah Johnson Porterfield
- Bruce Lyman Johnson
- Danna Suzanne Johnson
- Joseph N Johnson
All providers in Lebanon, TN · Physical Medicine & Rehabilitation Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.