Provider Demographics
NPI:1659551000
Name:SAMS, JOSIAH BAILEY (MD)
Entity Type:Individual
Prefix:
First Name:JOSIAH
Middle Name:BAILEY
Last Name:SAMS
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 1:2868 INDIAN TRL
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-5824
Mailing Address - Country:US
Mailing Address - Phone:423-581-5952
Mailing Address - Fax:423-581-2234
Practice Address - Street 1:2868 INDIAN TRL
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-5824
Practice Address - Country:US
Practice Address - Phone:423-581-5952
Practice Address - Fax:423-581-2234
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-13
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD29722085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN46562OtherBLUE CROSS OF TN.
TNB01652Medicare UPIN