Provider Demographics
NPI:1265567556
Name:SHOEMAKER, JAMES OFARRELL
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:OFARRELL
Last Name:SHOEMAKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1036 OAKHAVEN ROAD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119
Mailing Address - Country:US
Mailing Address - Phone:901-374-9600
Mailing Address - Fax:901-374-9030
Practice Address - Street 1:1036 OAKHAVEN RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-3812
Practice Address - Country:US
Practice Address - Phone:901-374-9600
Practice Address - Fax:901-374-9030
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS24391223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics