Provider Demographics
NPI:1063171429
Name:SCHWEITZER, JOSEPH LEON
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:LEON
Last Name:SCHWEITZER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 CORNWELL AVE
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37184-1045
Mailing Address - Country:US
Mailing Address - Phone:931-200-9518
Mailing Address - Fax:
Practice Address - Street 1:704 CADET CT
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-2647
Practice Address - Country:US
Practice Address - Phone:615-784-4056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-14
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN30735363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health