Provider Demographics
NPI:1528006673
Name:NAIFEH, JAMES EDWARD JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:EDWARD
Last Name:NAIFEH
Suffix:JR
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 1186
Mailing Address - Street 2:
Mailing Address - City:DYERSBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38025-1186
Mailing Address - Country:US
Mailing Address - Phone:731-285-0250
Mailing Address - Fax:731-285-9486
Practice Address - Street 1:640 US HIGHWAY 51 BYP E
Practice Address - Street 2:SUITE E
Practice Address - City:DYERSBURG
Practice Address - State:TN
Practice Address - Zip Code:38024-2067
Practice Address - Country:US
Practice Address - Phone:731-285-0250
Practice Address - Fax:731-285-9486
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN17884207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4030294OtherBLUECROSS BLUESHIELD TN
TN4030294OtherBLUECROSS BLUESHIELD TN
TN3042793Medicare ID - Type Unspecified