Provider Demographics
NPI:1558460451
Name:JAMES M BACHSTEIN, MD
Entity Type:Organization
Organization Name:JAMES M BACHSTEIN, MD
Other - Org Name:JAMES M BACHSTEIN, MD & ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:L
Authorized Official - Last Name:CRUTCHER
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:615-466-0041
Mailing Address - Street 1:112 BABB DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-2506
Mailing Address - Country:US
Mailing Address - Phone:615-466-0041
Mailing Address - Fax:615-466-0042
Practice Address - Street 1:112 BABB DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-2506
Practice Address - Country:US
Practice Address - Phone:615-466-0041
Practice Address - Fax:615-466-0042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000026422207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3092275Medicaid
TN368645OtherADVANTRA
TNCH9235OtherMEDICARE RR
TNG06206Medicare UPIN
TN3370236Medicare ID - Type Unspecified