Healthcare Provider Details

I. General information

NPI: 1346243458
Provider Name (Legal Business Name): THOMAS AUGUSTUS JANTZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 07/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4323 CAROTHERS PKWY STE 400
FRANKLIN TN
37067-5914
US

IV. Provider business mailing address

222 22ND AVE N STE 400
NASHVILLE TN
37203-1831
US

V. Phone/Fax

Practice location:
  • Phone: 615-791-4964
  • Fax: 615-791-9710
Mailing address:
  • Phone: 615-329-5144
  • Fax: 615-284-2751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number7228
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number7228
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: