Provider Demographics
NPI:1942306154
Name:SOLOMON, JAMES BERTRAM (DC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:BERTRAM
Last Name:SOLOMON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8029 RAY MEARS BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-2707
Mailing Address - Country:US
Mailing Address - Phone:865-337-5574
Mailing Address - Fax:865-313-8461
Practice Address - Street 1:8029 RAY MEARS BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-2707
Practice Address - Country:US
Practice Address - Phone:865-337-5574
Practice Address - Fax:865-313-8461
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
3971708Medicare PIN
U83471Medicare UPIN