Provider Demographics
NPI:1467553867
Name:JUDD, JAMES M (OD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:M
Last Name:JUDD
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:900 CONFERENCE DR
Mailing Address - Street 2:STE 15B
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-1909
Mailing Address - Country:US
Mailing Address - Phone:615-859-3937
Mailing Address - Fax:615-859-3919
Practice Address - Street 1:520 RIVERGATE PKWY
Practice Address - Street 2:
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-2030
Practice Address - Country:US
Practice Address - Phone:615-859-3937
Practice Address - Fax:615-859-3919
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2021-08-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN2275152W00000X
TNOD2275152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4070788OtherBCBS OF TENNESSEE
TN4194091OtherCIGNA HEALTHCARE
TN4076007OtherBLUE CROSS BLUE SHIELD OF TENNESSEE
TN5010210002Medicare NSC
5010210001Medicare NSC
TN3945487Medicare PIN
TN4194091OtherCIGNA HEALTHCARE