Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC1750 | TN |
N | 111NN1001X | Nutrition | DC1750 | TN |
NPI | 1124173125 |
---|---|
Provider Name | Dr. Jason Prentice Tharpe |
First Address | Franklin, TN 37067-5665 |
Second Address | Franklin, TN 37067-3029 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2007 |
Last Update Date | 24/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2322090 | AETNA HMO (01) | TN |
27-2654351 | TAX ID (01) | TN |
3971359 | (05) | TN |
4025774 | BCBS OF TENNESSEE (01) | TN |
616023 | ACN (01) | TN |
7620027 | AETNA PPO (01) | TN |
9194330 | PHCS (01) | TN |
957054 | FOCUS (01) | TN |
U82690 | (02) | TN |