Provider Demographics
NPI:1760436091
Name:HARRIS, JAMES THOMAS (DPM)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:THOMAS
Last Name:HARRIS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2051 S HWY 45 BYPASS
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:TN
Mailing Address - Zip Code:38382-3328
Mailing Address - Country:US
Mailing Address - Phone:731-855-1040
Mailing Address - Fax:731-855-3927
Practice Address - Street 1:2051 S HWY 45 BYPASS
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:TN
Practice Address - Zip Code:38382-3328
Practice Address - Country:US
Practice Address - Phone:731-855-1040
Practice Address - Fax:731-855-3927
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDPM646213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4294859OtherBLUE CROSS PIN
TN1790981066OtherMEDICARE GROUP NPI
TN4294859OtherBLUE CROSS PIN
TN1790981066OtherMEDICARE GROUP NPI