Provider Demographics
NPI:1821107574
Name:STAGGS, JAMES G (DO)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:G
Last Name:STAGGS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:753 HUMBLE DR STE B
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-4202
Mailing Address - Country:US
Mailing Address - Phone:931-520-1800
Mailing Address - Fax:931-520-1844
Practice Address - Street 1:753B HUMBLE DR
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-3777
Practice Address - Country:US
Practice Address - Phone:931-520-1800
Practice Address - Fax:931-520-1844
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNDO0000000995207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3083924OtherBCBS PROVIDER NUMBER
TN621531056OtherTAX ID
TNF49951Medicare UPIN
TN621531056OtherTAX ID