Provider Demographics
NPI:1063473569
Name:EZI-ASHI, JAMES CHIKE (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:CHIKE
Last Name:EZI-ASHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-1726
Mailing Address - Country:US
Mailing Address - Phone:931-783-5582
Mailing Address - Fax:931-526-6760
Practice Address - Street 1:438 N WHITNEY AVE
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501
Practice Address - Country:US
Practice Address - Phone:931-783-2616
Practice Address - Fax:931-783-2610
Is Sole Proprietor?:No
Enumeration Date:2006-04-01
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD417825207RG0100X, 207RI0008X
TN58011207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207RI0008XAllopathic & Osteopathic PhysiciansInternal MedicineHepatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA200554OtherHEALTH AMERICA
OH000000209404OtherANTHEM
PA0007022421OtherAETNA
PA0018864890001Medicaid
OH2413990Medicaid
PAP00079682OtherRAILROAD MEDICARE
PA1343115OtherHIGHMARK BC BS
PA3607952-001OtherCIGNA
PA1343115OtherHIGHMARK BC BS