Marvel, Jeffrey Blaine

Marvel, Jeffrey Blaine is an sole proprietor health care provider with primary practice located at 1821 N Washington St , Tullahoma TN 37388-2221. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Marvel, Jeffrey Blaine can be contacted via phone (931) 455-2005.

Contact Information

Primary practice address
1821 N Washington St Tullahoma TN 37388-2221
Phone: (931) 455-2005
Fax: (931) 455-4450
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 29420 Tennessee

Profile Details

NPI number 1740285063
LBN Legal business name Marvel, Jeffrey Blaine
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 14th, 2005
Last updated Oct 27th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740285063 NPPES
Tennessee MEDICAID 3812095
Tennessee Other 3057919

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