Provider Demographics
NPI:1750369260
Name:HARTWELL, JEFFREY DAVID (DC)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:DAVID
Last Name:HARTWELL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 COLLINS ST
Mailing Address - Street 2:
Mailing Address - City:CHURCH HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37642-4016
Mailing Address - Country:US
Mailing Address - Phone:423-226-3989
Mailing Address - Fax:423-226-3639
Practice Address - Street 1:211 COLLINS ST
Practice Address - Street 2:
Practice Address - City:CHURCH HILL
Practice Address - State:TN
Practice Address - Zip Code:37642-4016
Practice Address - Country:US
Practice Address - Phone:423-226-3989
Practice Address - Fax:423-226-3639
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-04
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3820111N00000X
TN3820111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR28833Medicare UPIN
ORR0000QGFSTMedicare ID - Type Unspecified