1366468423 NPI number — TAMARA JAMES M.D.

Table of content: TAMARA JAMES M.D. (NPI 1366468423)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366468423 NPI number — TAMARA JAMES M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JAMES
Provider First Name:
TAMARA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1366468423
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/02/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
160 N EAGLE CREEK DR
Provider Second Line Business Mailing Address:
SUITE 400
Provider Business Mailing Address City Name:
LEXINGTON
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40509-2121
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-258-5220
Provider Business Mailing Address Fax Number:
859-258-5405

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
160 N EAGLE CREEK DR
Provider Second Line Business Practice Location Address:
SUITE 400
Provider Business Practice Location Address City Name:
LEXINGTON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40509-2121
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-258-5220
Provider Business Practice Location Address Fax Number:
859-258-5405
Provider Enumeration Date:
07/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  26117 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4000501 . This is a "MEDICARE LAB GROUP#" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: CB5773 . This is a "RR MEDICARE GROUP#" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 37903705 . This is a "MEDICAID LAB GROUP#" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 36000818 . This is a "ASC MEDICAID GROUP#" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 64261175 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: ASC 1019 . This is a "ASC MEDICARE GROUP#" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com