Provider Demographics
NPI:1023076882
Name:OURS, DAVID E (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:E
Last Name:OURS
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 1:1027 N HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-2450
Mailing Address - Country:US
Mailing Address - Phone:615-895-2527
Mailing Address - Fax:615-895-7056
Practice Address - Street 1:1027 N HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-2450
Practice Address - Country:US
Practice Address - Phone:615-895-2527
Practice Address - Fax:615-895-7056
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2015-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD014254207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4082169OtherAETNA MC NUMBER
TN117039OtherAETNA PROVIDER
TN3003844Medicare ID - Type UnspecifiedMEDICARE NUMBER
TN4082169OtherPPO AETNA NUMBER
TNA96880Medicare UPIN
TN621269492OtherTAX ID NUMBER
TN000391245002OtherUNITED HEALTH CARE
TN0060724OtherBLUECROSS/BLUESHIELD
TN0080009307OtherMEDICARE RAILROAD
TNMD014254OtherLICENSE NUMBER