| Robert J Jantz | |
|
706 Cadet Ct Lebanon TN 37087-2649 | |
| (615) 449-2472 | |
| (615) 449-4709 |
| Full Name | Robert J Jantz |
|---|---|
| Speciality | Family Medicine |
| Location | 706 Cadet Ct, Lebanon, Tennessee |
| Authorized Official Name and Position | Robert Joseph Jantz (OWNER) |
| Authorized Official Contact | 6154492472 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Robert J Jantz 706 Cadet Ct Lebanon TN 37087-2649 Ph: (615) 449-2472 | Robert J Jantz 706 Cadet Ct Lebanon TN 37087-2649 Ph: (615) 449-2472 |
| NPI Number | 1104096288 |
|---|---|
| Provider Enumeration Date | 03/05/2008 |
| Last Update Date | 02/05/2020 |
| Medicare PECOS PAC ID | 4688614803 |
|---|---|
| Medicare Enrollment ID | O20050506000591 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104096288 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD18858 (Tennessee) | Primary |
| Provider Name | Robert Joseph Jantz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396751749 PECOS PAC ID: 7911947130 Enrollment ID: I20110223000239 |
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