Provider Demographics
NPI:1699825513
Name:BARHAM, JAMES ELDRED (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ELDRED
Last Name:BARHAM
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 1:7645 LEBANON CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:TALBOTT
Mailing Address - State:TN
Mailing Address - Zip Code:37877-8942
Mailing Address - Country:US
Mailing Address - Phone:865-475-7766
Mailing Address - Fax:
Practice Address - Street 1:1307 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37813-5453
Practice Address - Country:US
Practice Address - Phone:423-581-4100
Practice Address - Fax:423-581-4156
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN023961207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TND17889Medicare UPIN
TN3071577Medicare ID - Type Unspecified