Provider Demographics
NPI:1720001308
Name:UZZLE, JEFFREY A (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:A
Last Name:UZZLE
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 1:101 CRESTVIEW LN
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-7673
Mailing Address - Country:US
Mailing Address - Phone:865-294-5056
Mailing Address - Fax:865-685-0674
Practice Address - Street 1:150 E DIVISION RD
Practice Address - Street 2:SUITE 9
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-6938
Practice Address - Country:US
Practice Address - Phone:865-294-5056
Practice Address - Fax:865-685-0674
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN21640208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3061815Medicaid
TN103I723638Medicare PIN
TN3061815Medicaid
3061817Medicare PIN
TN3376148Medicare PIN
E91350Medicare UPIN