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NPI Code Detail

MEDICARE: DR. DEON TOLLIVER M.D.

MEDICARE: DR. DEON TOLLIVER M.D.
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
1207Q00000XFamily Medicine Physician55364TN
2207Q00000XFamily Medicine Physician58523KY

General Provider Information

NPI Number : 1780096933
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DEON TOLLIVER M.D.
Provider Business Mailing Address
First Line : 2711 FOSTER AVE
Second Line :
City : NASHVILLE
State : TN
Zip : 37210-5307
Country : US
Telephone Number : 615-620-8647
Fax Number :
Provider Business Practice Location Address
First Line : 217 E HIGH ST STE 200
Second Line :
City : LEBANON
State : TN
Zip : 37087-6709
Country : US
Telephone Number : 615-227-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2014
Last Update Date : 12/14/2023

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Directions to “ DR. DEON TOLLIVER M.D.” Practice Location

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