MEDICARE: DR. JOSEPH M GEBHARDT D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	1863	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4058005	OTHER	TN	BCBS

General Provider Information

NPI Number	:	1083612105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH M GEBHARDT D.C.

Provider Business Mailing Address
First Line	:	4825 TROUSDALE DR
Second Line	:	214
City	:	NASHVILLE
State	:	TN
Zip	:	37220-1335
Country	:	US
Telephone Number	:	615-331-5938
Fax Number	:

Provider Business Practice Location Address
First Line	:	4825 TROUSDALE DR
Second Line	:	214
City	:	NASHVILLE
State	:	TN
Zip	:	37220-1335
Country	:	US
Telephone Number	:	615-331-5938
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	07/08/2007

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