Provider Demographics
NPI:1184001257
Name:CONSTANT, JONATHAN SCOTT (DO)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:SCOTT
Last Name:CONSTANT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:892 RODNEY DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-3062
Mailing Address - Country:US
Mailing Address - Phone:270-282-5398
Mailing Address - Fax:
Practice Address - Street 1:1601 23RD AVE S STE 3104
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-3196
Practice Address - Country:US
Practice Address - Phone:615-327-7119
Practice Address - Fax:615-327-7136
Is Sole Proprietor?:No
Enumeration Date:2015-04-28
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program