Provider Demographics
NPI:1679591143
Name:TRAMONTANA, JAMES MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:MICHAEL
Last Name:TRAMONTANA
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 1:601 DODDS AVE
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404-3911
Mailing Address - Country:US
Mailing Address - Phone:423-826-8220
Mailing Address - Fax:423-698-3622
Practice Address - Street 1:990 OAK RIDGE TPKE
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-6976
Practice Address - Country:US
Practice Address - Phone:865-835-4600
Practice Address - Fax:865-835-4609
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS18627207R00000X
TN431002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN100055639OtherPHP-TNCARE
TN1882429OtherFIRST HEALTH
KY7100041330Medicaid
TN3001448Medicaid
TN702064735OtherPHP
TN3262740OtherCIGNA
TN418352OtherBCBS
TN4183592OtherBCBS OF TN
TN418352OtherBCBS
TN3001448Medicare PIN