Provider Demographics
NPI:1205651205
Name:UPTON, JAMES ROBERT (DPT, PT)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:ROBERT
Last Name:UPTON
Suffix:
Gender:M
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6600 STAGE RD STE 129
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38134-3838
Mailing Address - Country:US
Mailing Address - Phone:901-371-0732
Mailing Address - Fax:901-371-0859
Practice Address - Street 1:8390 HWY 51 NORTH, STE 101
Practice Address - Street 2:
Practice Address - City:MILLINGTON
Practice Address - State:TN
Practice Address - Zip Code:38053-1632
Practice Address - Country:US
Practice Address - Phone:901-872-6422
Practice Address - Fax:901-872-6497
Is Sole Proprietor?:No
Enumeration Date:2024-11-15
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN15995225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist