Healthcare Provider Details

I. General information

NPI: 1730370610
Provider Name (Legal Business Name): DON J ELAZAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2007
Last Update Date: 08/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 EAST MAIN STREET STE 200
GALLATIN TN
37066
US

IV. Provider business mailing address

695 NASHVILLE PIKE #313
GALLATIN TN
37066
US

V. Phone/Fax

Practice location:
  • Phone: 615-206-9111
  • Fax: 615-206-9212
Mailing address:
  • Phone: 615-206-9111
  • Fax: 615-206-9212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number35261
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: