Provider Demographics
NPI:1366654048
Name:KIRKPATRICK, JAMES III (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:KIRKPATRICK
Suffix:III
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 40
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTON
Mailing Address - State:TN
Mailing Address - Zip Code:37644-0040
Mailing Address - Country:US
Mailing Address - Phone:423-542-2738
Mailing Address - Fax:423-543-2421
Practice Address - Street 1:922 W G ST
Practice Address - Street 2:
Practice Address - City:ELIZABETHTON
Practice Address - State:TN
Practice Address - Zip Code:37643-2935
Practice Address - Country:US
Practice Address - Phone:423-542-2738
Practice Address - Fax:423-543-2421
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN43788207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3001829Medicaid
TN3001829Medicaid