Provider Demographics
NPI:1720177827
Name:BOMBOY, JAMES D JR (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:D
Last Name:BOMBOY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:501 GREAT CIRCLE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228-1317
Mailing Address - Country:US
Mailing Address - Phone:615-284-4672
Mailing Address - Fax:615-284-5752
Practice Address - Street 1:2000 CHURCH ST
Practice Address - Street 2:IP HOSPITALIST
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37236-0002
Practice Address - Country:US
Practice Address - Phone:615-284-4672
Practice Address - Fax:615-284-5752
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN8197207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4273099OtherBCBS
TN1520588Medicaid
TN3382592Medicaid
TND70187Medicare UPIN
TN103I110623Medicare PIN
TN4273099OtherBCBS