Provider Demographics
NPI:1588637615
Name:ZWEMER, RODGER J JR (MD)
Entity Type:Individual
Prefix:
First Name:RODGER
Middle Name:J
Last Name:ZWEMER
Suffix:JR
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 1:521 MEDICAL DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:LIVINGSTON
Mailing Address - State:TN
Mailing Address - Zip Code:38570-1879
Mailing Address - Country:US
Mailing Address - Phone:931-403-6093
Mailing Address - Fax:931-403-2615
Practice Address - Street 1:521 MEDICAL DR
Practice Address - Street 2:SUITE A
Practice Address - City:LIVINGSTON
Practice Address - State:TN
Practice Address - Zip Code:38570-1879
Practice Address - Country:US
Practice Address - Phone:931-403-6093
Practice Address - Fax:931-403-2615
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-09
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD25850207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3087958Medicaid
TN37164741OtherMEDICARE GROUP
TN30879581Medicare PIN