Provider Demographics
NPI:1063467876
Name:ELROD, JAMES T JR (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:T
Last Name:ELROD
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:222 22ND AVE N
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1852
Mailing Address - Country:US
Mailing Address - Phone:629-255-3486
Mailing Address - Fax:
Practice Address - Street 1:325 OLD PLEASANT GROVE RD
Practice Address - Street 2:
Practice Address - City:MT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-4493
Practice Address - Country:US
Practice Address - Phone:629-255-2106
Practice Address - Fax:629-255-4169
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN15888207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3017034Medicaid
TN3017039Medicare PIN
TN103117I085Medicare PIN
TN3017034Medicaid
TNB58909Medicare UPIN
TN0059348OtherBCBS
TN0059348OtherTENNCARE
TNP2842749OtherFIRST HEALTH
TNB58909OtherHEALTHSPRING
TN3017039Medicare PIN