Provider Demographics
NPI:1083612105
Name:GEBHARDT, JOSEPH M (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:M
Last Name:GEBHARDT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4825 TROUSDALE DR
Mailing Address - Street 2:214
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37220-1335
Mailing Address - Country:US
Mailing Address - Phone:615-331-5938
Mailing Address - Fax:
Practice Address - Street 1:4825 TROUSDALE DR
Practice Address - Street 2:214
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37220-1335
Practice Address - Country:US
Practice Address - Phone:615-331-5938
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1863111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4058005OtherBCBS
TN4058005OtherBCBS
TN3973035Medicare ID - Type Unspecified