Provider Demographics
NPI:1568597102
Name:DELOZIER, JOSEPH B III (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:B
Last Name:DELOZIER
Suffix:III
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 1:209 23RD AVE N
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1501
Mailing Address - Country:US
Mailing Address - Phone:615-565-9000
Mailing Address - Fax:615-565-9005
Practice Address - Street 1:209 23RD AVE N
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1501
Practice Address - Country:US
Practice Address - Phone:615-565-9000
Practice Address - Fax:615-565-9005
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN16595208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNE82289Medicare UPIN
TN3059369Medicare ID - Type UnspecifiedIND MEDCARE #