Peavyhouse, Joel Q

Peavyhouse, Joel Q is an individual health care provider with primary practice located at 417 Northcrest Dr , Springfield TN 37172-3973. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Peavyhouse, Joel Q can be contacted via phone (615) 382-5204.

Contact Information

Primary practice address
417 Northcrest Dr Springfield TN 37172-3973
Phone: (615) 382-5204
Fax: (615) 382-4952
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X MD6335 Tennessee

Profile Details

NPI number 1568457042
LBN Legal business name Peavyhouse, Joel Q
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 12th, 2005
Last updated Jul 8th, 2007 - about 17 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 1568457042 NPPES
Tennessee Other 4060714 TENNCARE BCBS
Tennessee MEDICAID 3165033 TENNCARE BCBS

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