Provider Demographics
NPI:1407033376
Name:PANTIN, JEREMY MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:MARK
Last Name:PANTIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2410 PATTERSON ST STE 500
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-6521
Mailing Address - Country:US
Mailing Address - Phone:615-342-4912
Mailing Address - Fax:615-342-4913
Practice Address - Street 1:2410 PATTERSON ST STE 500
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-6521
Practice Address - Country:US
Practice Address - Phone:615-342-4912
Practice Address - Fax:615-342-4913
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-23
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA066390207RH0003X
MDD0066141207RH0003X
TN58064207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology