Provider Demographics
NPI:1164443271
Name:BAZZI, JAMES S (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:S
Last Name:BAZZI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JAMAL
Other - Middle Name:S
Other - Last Name:BAZZI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 1240
Mailing Address - Street 2:315 HOSPITAL DRIVE STE 4
Mailing Address - City:BARBOURVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40906
Mailing Address - Country:US
Mailing Address - Phone:606-546-6624
Mailing Address - Fax:606-545-9326
Practice Address - Street 1:3600 CUMBERLAND AVE
Practice Address - Street 2:
Practice Address - City:MIDDLESBORO
Practice Address - State:KY
Practice Address - Zip Code:40965-2614
Practice Address - Country:US
Practice Address - Phone:606-242-1463
Practice Address - Fax:606-242-1468
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY39345207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYI33407Medicare UPIN