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NPI Code Detail

MEDICARE: JASON M VANATTA MD

MEDICARE: JASON M VANATTA MD
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
1204F00000XTransplant Surgery Physician42475TN
2208600000XSurgery Physician61282KY
3208600000XSurgery Physician42475TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1366452484
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASON M VANATTA MD
Provider Business Mailing Address
First Line : 9035 TELLURIDE CV
Second Line :
City : GERMANTOWN
State : TN
Zip : 38138-8400
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1265 UNION AVE, 4 SHORB TOWER
Second Line :
City : MEMPHIS
State : TN
Zip : 38104-3415
Country : US
Telephone Number : 901-478-9183
Fax Number : 901-478-8957
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2006
Last Update Date : 10/08/2025

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Directions to “ JASON M VANATTA MD” Practice Location

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