1144227067 NPI number — DR. JAMES R NUNLEY DO

Table of content: DR. JAMES R NUNLEY DO (NPI 1144227067)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144227067 NPI number — DR. JAMES R NUNLEY DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NUNLEY
Provider First Name:
JAMES
Provider Middle Name:
R
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
M

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:
1144227067
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/17/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 299
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MANCHESTER
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37349-0299
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
931-728-5607
Provider Business Mailing Address Fax Number:
931-728-8354

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2345 MURFREESBORO HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MANCHESTER
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37355-3206
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
931-728-5607
Provider Business Practice Location Address Fax Number:
931-728-8354
Provider Enumeration Date:
07/07/2005

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: 207LP2900X , with the licence number:  DO575 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0016412 . This is a "BLUE SHIELD" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 31492 . This is a "HEALTH 123" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 2040121 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 1504783003 . This is a "CIGNA PLAN 139" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 1504783004 . This is a "CIGNA PLAN 110" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 4539564 . This is a "AETNA PPO" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 050015171 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 2037664 . This is a "AETNA HMO" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 3302825 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".




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