Provider Demographics
NPI:1164450391
Name:ULMER, JAMES STANLEY (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:STANLEY
Last Name:ULMER
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:PO BOX 24686
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37422-4686
Mailing Address - Country:US
Mailing Address - Phone:877-288-1799
Mailing Address - Fax:423-892-5838
Practice Address - Street 1:1 SAINT FRANCIS DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-3955
Practice Address - Country:US
Practice Address - Phone:864-255-1000
Practice Address - Fax:864-269-1361
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8899207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC88997Medicaid
SC050032392Medicare PIN
B92046Medicare UPIN
SC88997Medicaid