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Individual

JACOB C DEXHEIMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2300 PATTERSON ST, NASHVILLE, TN 37203-1538
(615) 342-6828
(615) 342-6836
Mailing address
2300 PATTERSON ST, NASHVILLE, TN 37203-1538
(615) 342-6828
(615) 342-6836

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
43525
TN
208M00000X
Hospitalist Physician
43525
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01287075
AMERIGROUP
TN
05
1513451
TN
01
4230166
BCBST
TN
01
7100072080
KY MEDICAID
KY
01
9173358
AETNA
01
P00730712
RAILROAD MEDICARE
TN
Enumeration date
01/04/2007
Last updated
03/31/2017
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