Provider Demographics
NPI:1922092535
Name:JOBE, JEFFREY S (MD)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:S
Last Name:JOBE
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 1:5006 SPEDALE CT
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174-6105
Mailing Address - Country:US
Mailing Address - Phone:615-302-0701
Mailing Address - Fax:615-302-0780
Practice Address - Street 1:5006 SPEDALE CT
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174-6105
Practice Address - Country:US
Practice Address - Phone:615-302-0701
Practice Address - Fax:615-302-0780
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD38960207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4090612OtherBLUE CROSS BLUE SHIELD
TN3895312Medicaid
TN3895313Medicaid
TN3895312Medicare PIN
TN3895313Medicare PIN
TN4090612OtherBLUE CROSS BLUE SHIELD
TNI12953Medicare UPIN
TNP00313712Medicare PIN