Provider Demographics
NPI:1730129735
Name:WINDER, JAMES BERNARD III (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:BERNARD
Last Name:WINDER
Suffix:III
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 1:2344 DAWNS PASS
Mailing Address - Street 2:SUITE 300
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-9103
Mailing Address - Country:US
Mailing Address - Phone:865-776-1295
Mailing Address - Fax:
Practice Address - Street 1:886 HIGHWAY 411 N
Practice Address - Street 2:
Practice Address - City:ETOWAH
Practice Address - State:TN
Practice Address - Zip Code:37331-1912
Practice Address - Country:US
Practice Address - Phone:423-263-3600
Practice Address - Fax:423-263-3601
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS13136207P00000X
TN26303207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSP00451596OtherRAILROAD MCARE
MS00125207Medicaid
LA1367664Medicaid
TN1508722Medicaid
MSP00833978OtherRAILROAD MCARE THRU HCCN
TN4185191OtherBCBS OF TN
TNP00667675OtherRAILROAD MCARE THRU AMS
LA1367664Medicaid
MSP00451596OtherRAILROAD MCARE
TN4185191OtherBCBS OF TN
MS302I937486Medicare PIN