Provider Demographics
NPI:1588634760
Name:PEOPLES, JAMES T (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:T
Last Name:PEOPLES
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:PO BOX 23996
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39225
Mailing Address - Country:US
Mailing Address - Phone:601-206-6100
Mailing Address - Fax:601-206-6052
Practice Address - Street 1:1200 N STATE ST
Practice Address - Street 2:SUITE 480
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39202-2001
Practice Address - Country:US
Practice Address - Phone:601-352-2273
Practice Address - Fax:601-714-3415
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2013-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN46824207R00000X
MS19390207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN260432900Medicaid
MS04707398Medicaid
MNP00198305Medicare ID - Type UnspecifiedRAILROAD
MN110009807Medicare ID - Type Unspecified
MN260432900Medicaid
I18378Medicare UPIN
MS110001999Medicare PIN