Provider Demographics
NPI:1770630667
Name:COLFAX, JOHN DREW (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:DREW
Last Name:COLFAX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:ONE VANTAGE WAY
Mailing Address - Street 2:SUITE B240
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228
Mailing Address - Country:US
Mailing Address - Phone:615-329-4020
Mailing Address - Fax:615-329-9479
Practice Address - Street 1:400 NORTH HIGHLAND AVENUE
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130
Practice Address - Country:US
Practice Address - Phone:615-596-3455
Practice Address - Fax:615-396-6963
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN42461207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3000317Medicaid
TN3000317Medicaid