Provider Demographics
NPI:1104804228
Name:SHUSTER, JOHN LEE JR (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:LEE
Last Name:SHUSTER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 SINCLAIR CIRCLE
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027
Mailing Address - Country:US
Mailing Address - Phone:615-720-8971
Mailing Address - Fax:
Practice Address - Street 1:405 DUKE DR
Practice Address - Street 2:SUITE 210
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-2706
Practice Address - Country:US
Practice Address - Phone:844-291-4535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2017-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD00000459962084P0015X, 2084P0800X, 2084H0002X
AL158042084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine
No2084H0002XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyHospice and Palliative Medicine