Provider Demographics
NPI:1407962053
Name:ROJAS, JORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:JORGE
Middle Name:
Last Name:ROJAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2571 HENRY GOWER RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANT VIEW
Mailing Address - State:TN
Mailing Address - Zip Code:37146-9067
Mailing Address - Country:US
Mailing Address - Phone:615-746-4308
Mailing Address - Fax:615-746-0928
Practice Address - Street 1:2571 HENRY GOWER RD
Practice Address - Street 2:
Practice Address - City:PLEASANT VIEW
Practice Address - State:TN
Practice Address - Zip Code:37146-9067
Practice Address - Country:US
Practice Address - Phone:615-746-4308
Practice Address - Fax:615-746-0928
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN111292080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3170081Medicaid
TND32056Medicare UPIN
TN3170081Medicaid