Provider Demographics
NPI:1568429124
Name:VARNER, JAMES CARROLL (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:CARROLL
Last Name:VARNER
Suffix:
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 1:1160 CHEMBERRY PL
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-4073
Mailing Address - Country:US
Mailing Address - Phone:901-482-4238
Mailing Address - Fax:901-482-4238
Practice Address - Street 1:1160 CHEMBERRY PL
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-4073
Practice Address - Country:US
Practice Address - Phone:901-482-4238
Practice Address - Fax:901-482-4238
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS11311207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3075830Medicaid
TN3002925OtherBLUE CROSS BLUE SHIELD
TN2597686002OtherCIGNA
MS00095896Medicaid
TN3002925OtherBLUE CROSS BLUE SHIELD
MS00095896Medicaid
MS396417ZL5SMedicare PIN
MSP00016524Medicare PIN
MS0666250001Medicare NSC