Individual
MR. JOSEPH TYE PREWITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3601 THE VANDERBILT CLINIC, NASHVILLE, TN 37232-6601
(615) 322-3000
Mailing address
3841 GREEN HILLS VILLAGE DR STE 200, NASHVILLE, TN 37215-2691
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6005
TN
363A00000X
Physician Assistant
PA1769
KY
363AM0700X
Medical Physician Assistant
PA1769
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100252880
—
KY
01
—
P01438910
RR MEDICARE
KY
Enumeration date
05/03/2013
Last updated
09/11/2024
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