Provider Demographics
NPI:1730370610
Name:ELAZAR, DON J (MD)
Entity type:Individual
Prefix:
First Name:DON
Middle Name:J
Last Name:ELAZAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:695 NASHVILLE PIKE
Mailing Address - Street 2:#313
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066
Mailing Address - Country:US
Mailing Address - Phone:615-206-9111
Mailing Address - Fax:615-206-9212
Practice Address - Street 1:214 EAST MAIN STREET
Practice Address - Street 2:STE 200
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066
Practice Address - Country:US
Practice Address - Phone:615-206-9111
Practice Address - Fax:615-206-9212
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN352612084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3726901Medicaid
TN3879765Medicare PIN
F95353Medicare UPIN