Basic Information
| Provider Information | |||||||||
| NPI: | 1811158942 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCDUFFIE | ||||||||
| FirstName: | JEREMY | ||||||||
| MiddleName: | SCOTT | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 440100 | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372440100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153290570 | ||||||||
| FaxNumber: | 6159049061 | ||||||||
| Practice Location | |||||||||
| Address1: | 1840 MEDICAL CENTER PKWY | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | MURFREESBORO | ||||||||
| State: | TN | ||||||||
| PostalCode: | 371293199 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6158480488 | ||||||||
| FaxNumber: | 6159049061 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/20/2008 | ||||||||
| LastUpdateDate: | 10/02/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | 53413 | TN | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | 174400000X | 071827 | GA | N | Other Service Providers | Specialist |
ID Information
| ID | Type | State | Issuer | Description | 1811158942 | 01 | GA | NPI NUMBER | OTHER |