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NPI Code Detail

MEDICARE: JORDAN NICHOLAS JAMES YUTZY

MEDICARE: JORDAN NICHOLAS JAMES YUTZY
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
1207P00000XEmergency Medicine Physician76946TN
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1952151243
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORDAN NICHOLAS JAMES YUTZY
Provider Business Mailing Address
First Line : 1840 MEDICAL CENTER PKWY STE 403
Second Line :
City : MURFREESBORO
State : TN
Zip : 37129-3237
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 920 MADISON AVE STE 447
Second Line :
City : MEMPHIS
State : TN
Zip : 38103-3438
Country : US
Telephone Number : 615-396-6449
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2024
Last Update Date : 05/29/2026

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