Provider Demographics
NPI:1235270042
Name:DAVIS, JAMES V
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:V
Last Name:DAVIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:446 METROPLEX DR
Mailing Address - Street 2:SUITE A-100
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-3139
Mailing Address - Country:US
Mailing Address - Phone:615-781-0013
Mailing Address - Fax:615-781-0688
Practice Address - Street 1:417 HARDING DR
Practice Address - Street 2:SUITE B
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-3925
Practice Address - Country:US
Practice Address - Phone:615-453-1606
Practice Address - Fax:615-453-1607
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3376955Medicare ID - Type UnspecifiedGROUP NUMBER