Individual
DR. JOHN CONARD BELITZ IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1855 TANNER WAY, SUITE 200, HARRIMAN, TN 37748-2057
(865) 376-6272
(865) 376-0341
Mailing address
1855 TANNER WAY, SUITE 200, HARRIMAN, TN 37748-2057
(865) 376-6272
(865) 376-0341
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
039463
TN
208000000X
Pediatrics Physician
039463
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3069138
RAILROAD MEDICARE
TN
05
—
3069138
—
TN
05
—
Q066118
—
TN
Enumeration date
03/29/2006
Last updated
06/25/2021
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