Provider Demographics
NPI:1225250640
Name:JAMES, TERRY MATTHEW (MD)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:MATTHEW
Last Name:JAMES
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 1:16356 COUNTY ROAD 41
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:AL
Mailing Address - Zip Code:35540-2416
Mailing Address - Country:US
Mailing Address - Phone:256-747-1186
Mailing Address - Fax:256-747-1196
Practice Address - Street 1:16356 COUNTY ROAD 41
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:AL
Practice Address - Zip Code:35540-2416
Practice Address - Country:US
Practice Address - Phone:256-747-1186
Practice Address - Fax:256-747-1196
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALL-2816207Q00000X
AL28387207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL111855Medicaid
ALP00733325OtherMEDICARE RR
AL1225250640OtherUNITED HEALTH CARE
AL1598717381OtherMEDICAID PAYEE
AL102I080435OtherMEDICARE
ALE869OtherMEDICARE GROUP
ALP00733325Medicare PIN