Healthcare Provider Details

I. General information

NPI: 1689710485
Provider Name (Legal Business Name): JAN ALAN MAYER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8283 RIVER ROAD PIKE
NASHVILLE TN
37209-6018
US

IV. Provider business mailing address

PO BOX 92225
NASHVILLE TN
37209-8225
US

V. Phone/Fax

Practice location:
  • Phone: 615-690-4572
  • Fax: 615-354-1577
Mailing address:
  • Phone: 615-690-4572
  • Fax: 615-354-1577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License NumberTN0000010148
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: