Individual
JAYANT B MEHTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
310 N STATE OF FRANKLIN RD, SUITE 303, JOHNSON CITY, TN 37604-6008
(423) 926-8181
(423) 926-8652
Mailing address
310 N STATE OF FRANKLIN RD, SUITE 303, JOHNSON CITY, TN 37604-6008
(423) 926-8181
(423) 926-8652
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
10547
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3166130
—
TN
Enumeration date
06/29/2006
Last updated
06/17/2011
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