Individual
DR. JEREMY NATHAN ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
301 MED TECH PKWY STE 240, JOHNSON CITY, TN 37604-2641
(423) 794-5520
(423) 282-6940
Mailing address
PO BOX 632476, CINCINNATI, OH 45263-2476
(423) 794-5520
(423) 282-6940
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
02971
KY
207Q00000X
Family Medicine Physician
Primary
DO1936
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124043120
—
VA
01
—
P00855440
RR MCARE
TN
05
—
Q003323
—
TN
Enumeration date
07/12/2006
Last updated
02/18/2025
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