Provider Demographics
NPI:1841387958
Name:WENDEL, JAMES JASON (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:JASON
Last Name:WENDEL
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 1:2103 CRESTMOOR RD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2614
Mailing Address - Country:US
Mailing Address - Phone:615-921-2100
Mailing Address - Fax:615-921-2101
Practice Address - Street 1:2103 CRESTMOOR RD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215
Practice Address - Country:US
Practice Address - Phone:615-921-2100
Practice Address - Fax:615-921-2101
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-09
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD36486208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103I243540OtherMEDICARE PTAN
TN3876906Medicaid
H68352Medicare UPIN