Provider Demographics
NPI:1699746545
Name:LEAVITT, NATHAN ERIC (DC)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:ERIC
Last Name:LEAVITT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:NATHAN
Other - Middle Name:ERIC
Other - Last Name:LEAVITT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:6311 KINGSTON PIKE STE 28W
Mailing Address - Street 2:HTTP://WWW.DRNATHANLEAVITT.COM
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-4900
Mailing Address - Country:US
Mailing Address - Phone:865-287-5904
Mailing Address - Fax:865-512-1412
Practice Address - Street 1:6311 KINGSTON PIKE STE 28W
Practice Address - Street 2:HTTP://WWW.DRNATHANLEAVITT.COM
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-4900
Practice Address - Country:US
Practice Address - Phone:865-287-5904
Practice Address - Fax:865-512-1412
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC2046111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN2390911OtherCIGNA
TN4130528OtherBCBS
TN2390911OtherCIGNA
TNU93970Medicare UPIN