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General NPI Number Information
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NPI Number | 1992170658
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Entity Type | Organization
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Legal Business Name | JOHAN VAN JAARSVELD MD PLLC
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Dates
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Enumeration Date | 12/07/2015
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Last Update Date | 12/07/2015
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Provider Practice Location Address
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Address Line | 397 WALLACE RD SUITE 415
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City | NASHVILLE
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State | TN
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Zip | 37211-4854
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Country | US
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Telephone | 615-834-9781
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Fax | 615-834-0864
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Provider Business Mailing Address
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Address Line | 397 WALLACE RD SUITE 415
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City | NASHVILLE
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State | TN
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Zip | 37211-4854
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Country | US
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Telephone | 615-834-9781
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Fax | 615-834-0864
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Authorized Official
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Title or Position | OWNER
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Name | JOHAN VAN JAARSVELD
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Credential | M.D.
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Telephone | 615-834-9781
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 52609
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 52609
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License Number State | TN
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