Provider Demographics
NPI:1346243458
Name:JANTZ, THOMAS AUGUSTUS (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:AUGUSTUS
Last Name:JANTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:222 22ND AVE N
Mailing Address - Street 2:STE 400
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1831
Mailing Address - Country:US
Mailing Address - Phone:615-329-5144
Mailing Address - Fax:615-284-2751
Practice Address - Street 1:4323 CAROTHERS PKWY
Practice Address - Street 2:STE 400
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-5914
Practice Address - Country:US
Practice Address - Phone:615-791-4964
Practice Address - Fax:615-791-9710
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2012-07-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN7228174400000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3048751Medicaid
TNA99038Medicare UPIN
TN3048756Medicare ID - Type Unspecified