Provider Demographics
NPI:1013940840
Name:ZUPPA, JAMES R (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:R
Last Name:ZUPPA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:102 N OAKS DR
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30721-8392
Mailing Address - Country:US
Mailing Address - Phone:706-270-9989
Mailing Address - Fax:706-259-9601
Practice Address - Street 1:102 N OAKS DR
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30721-8392
Practice Address - Country:US
Practice Address - Phone:706-270-9989
Practice Address - Fax:706-259-9601
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA030249207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA52526190OtherBCBS GA
GAD31958Medicare UPIN
GA08BBVDGMedicare PIN