Provider Demographics
NPI:1184645657
Name:FOSTER, JAMES WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:WILLIAM
Last Name:FOSTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5562 MEADOW WELLS DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37924-3132
Mailing Address - Country:US
Mailing Address - Phone:865-604-3615
Mailing Address - Fax:877-992-3832
Practice Address - Street 1:816 MIDDLE CREEK RD
Practice Address - Street 2:
Practice Address - City:SEVIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37862-5017
Practice Address - Country:US
Practice Address - Phone:865-365-4675
Practice Address - Fax:865-365-4697
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN018742207R00000X
GA66785207R00000X
NC2012-00891207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3034451Medicaid
TN3034451Medicare ID - Type Unspecified
TN3034451Medicaid