Provider Demographics
NPI:1578586269
Name:ULIBARRI, JAMES A (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:ULIBARRI
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 1:281 N LYERLY ST STE 300
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404-2728
Mailing Address - Country:US
Mailing Address - Phone:423-693-2175
Mailing Address - Fax:888-959-1015
Practice Address - Street 1:281 N LYERLY ST STE 300
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-2728
Practice Address - Country:US
Practice Address - Phone:423-693-2175
Practice Address - Fax:888-959-1015
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN40941207XS0117X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP00331256OtherRAILROAD MEDICARE
TN7633780OtherAETNA
TN4129282OtherBLUECROSS BLUESHIELD
TNTN01L4OtherJOHNDEERE HEALTHCARE
TN4129282OtherBLUECROSS BLUESHIELD
TNP00331256OtherRAILROAD MEDICARE
H51543Medicare UPIN
TN3821034Medicare ID - Type Unspecified