Provider Demographics
NPI:1457329385
Name:NAVORSKA, DAVID REUEL (DO)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:REUEL
Last Name:NAVORSKA
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 1:550 TOWN CREEK RD E
Mailing Address - Street 2:SUITE 204
Mailing Address - City:LENOIR CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37772-6289
Mailing Address - Country:US
Mailing Address - Phone:865-647-3360
Mailing Address - Fax:865-647-3369
Practice Address - Street 1:AAFMH
Practice Address - Street 2:650 JOEL DRIVE
Practice Address - City:FORT CAMPBELL
Practice Address - State:KY
Practice Address - Zip Code:42223-3563
Practice Address - Country:US
Practice Address - Phone:270-956-0077
Practice Address - Fax:865-647-3369
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDO1166207Q00000X
TN1166207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN5082544OtherAETNA
TNP00233206OtherMEDICARE - RAILROAD
TN3766580OtherCIGNA
TN100010271OtherPHP TNCARE
TN4108906OtherBCBS
TN602004441OtherCARITEN
TN3304732Medicaid
TN3704598Medicaid
TNTN0145OtherUHC/JD
TN602004441OtherCARITEN
TNTN0145OtherUHC/JD
TNP00233206OtherMEDICARE - RAILROAD
TN3304732Medicaid