Provider Demographics
NPI:1659337855
Name:WHELESS, JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:WHELESS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:850 POPLAR AVE
Mailing Address - Street 2:BLDG 2
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38105-4607
Mailing Address - Country:US
Mailing Address - Phone:901-287-5674
Mailing Address - Fax:901-287-6804
Practice Address - Street 1:848 ADAMS AVE.
Practice Address - Street 2:STE. L400
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38105
Practice Address - Country:US
Practice Address - Phone:901-287-7337
Practice Address - Fax:901-287-4540
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN396462084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3328710Medicaid
E14768Medicare UPIN
TN3328710Medicaid