Provider Demographics
NPI:1942254743
Name:OVERBAY, JONATHAN E (BSPT)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:E
Last Name:OVERBAY
Suffix:
Gender:M
Credentials:BSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 681478
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37068
Mailing Address - Country:US
Mailing Address - Phone:866-800-9147
Mailing Address - Fax:615-591-6601
Practice Address - Street 1:28 WHITE BRIDGE RD
Practice Address - Street 2:110
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205
Practice Address - Country:US
Practice Address - Phone:615-356-9935
Practice Address - Fax:615-356-9489
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1878225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN446631Medicare ID - Type UnspecifiedGROUP