Provider Demographics
NPI:1306047501
Name:LOVELAND, JEFFREY D (DPM)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:D
Last Name:LOVELAND
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:415 SEWELL DR
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:TN
Mailing Address - Zip Code:38583-1223
Mailing Address - Country:US
Mailing Address - Phone:931-738-1026
Mailing Address - Fax:931-738-1027
Practice Address - Street 1:415 SEWELL DR
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:TN
Practice Address - Zip Code:38583-1223
Practice Address - Country:US
Practice Address - Phone:931-738-1026
Practice Address - Fax:931-738-1027
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNDPM0000000671213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
5965620001Medicare NSC