Provider Demographics
NPI:1316406614
Name:JAFF, AVAN (MD)
Entity Type:Individual
Prefix:DR
First Name:AVAN
Middle Name:
Last Name:JAFF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1060 PEERLESS XING NW STE 200
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312-3785
Mailing Address - Country:US
Mailing Address - Phone:423-479-4165
Mailing Address - Fax:423-476-9360
Practice Address - Street 1:1060 PEERLESS XING NW STE 200
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-3785
Practice Address - Country:US
Practice Address - Phone:423-479-4165
Practice Address - Fax:423-476-9360
Is Sole Proprietor?:No
Enumeration Date:2019-03-16
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN65686207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine