Dewitt, Jan Allen

Dewitt, Jan Allen is an individual health care provider with primary practice located at 109 Land Oak Rd , Knoxville TN 37922-2011. He recently has 3 registered licenses in different health care specialties including Emergency Medical Service Providers / Personal Emergency Response Attendant, Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Dewitt, Jan Allen can be contacted via phone (865) 777-1300.

Contact Information

Primary practice address
109 Land Oak Rd Knoxville TN 37922-2011
Phone: (865) 777-1300
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Emergency Medical Service Providers / Personal Emergency Response Attendant 146D00000X 21904 West Virginia
Other Service Providers / Specialist 174400000X 21904 West Virginia
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 33357 Kentucky

Profile Details

NPI number 1154351971
LBN Legal business name Dewitt, Jan Allen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 4th, 2006
Last updated Dec 14th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154351971 NPPES
Kentucky MEDICAID 64039050

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