Provider Demographics
NPI:1184602898
Name:DAVIS, JAMES ALLEN (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:ALLEN
Last Name:DAVIS
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 1:2717 EAST OAKLAND AVENUE
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-1843
Mailing Address - Country:US
Mailing Address - Phone:423-926-2358
Mailing Address - Fax:423-926-2680
Practice Address - Street 1:122 CAVETTE HILL LANE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934
Practice Address - Country:US
Practice Address - Phone:865-777-9000
Practice Address - Fax:812-376-0678
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN39047208M00000X, 207R00000X
IN01065259A208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4090130OtherBLUECROSS
TN7927251OtherAETNA
IN000000991122OtherANTHEM PIN
IN200953950Medicaid
TN3898006Medicaid
TN64095862Medicaid
TN7927251OtherAETNA
TN64095862Medicaid