Ivey, Donathan M

Ivey, Donathan M is an individual health care provider with primary practice located at 100 Lantana Road Suite 202, Crossville TN 38555-1903. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Ivey, Donathan M can be contacted via phone (931) 484-5141.

Contact Information

Primary practice address
100 Lantana Road Suite 202 Crossville TN 38555-1903
Phone: (931) 484-5141
Fax: (931) 484-5620
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X MD10079 Tennessee

Profile Details

NPI number 1427164557
LBN Legal business name Ivey, Donathan M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 22nd, 2006
Last updated Dec 8th, 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 1427164557 NPPES
Tennessee MEDICAID 3185096
Tennessee Other 406021123
Tennessee Other 58256

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