Provider Demographics
NPI:1386672483
Name:RODGERS, JAMES S (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:S
Last Name:RODGERS
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 1:1410 TUSCULUM BLVD
Mailing Address - Street 2:SUITE 1700
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37745-4286
Mailing Address - Country:US
Mailing Address - Phone:423-787-7100
Mailing Address - Fax:423-787-7109
Practice Address - Street 1:1410 TUSCULUM BLVD
Practice Address - Street 2:SUITE 1700
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745-4286
Practice Address - Country:US
Practice Address - Phone:423-787-7100
Practice Address - Fax:423-787-7109
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN06350207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN110191544OtherRR MEDICARE PIN
TN3172180Medicaid
TNQ000353Medicaid
TN110191544OtherRR MEDICARE PIN
TN103I110057Medicare PIN