Provider Demographics
NPI:1801099130
Name:WEEKS, JAMES KELLEY (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:KELLEY
Last Name:WEEKS
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:PO BOX 171206
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38187-1206
Mailing Address - Country:US
Mailing Address - Phone:901-765-2190
Mailing Address - Fax:901-765-3241
Practice Address - Street 1:5959 PARK AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-5200
Practice Address - Country:US
Practice Address - Phone:901-765-2190
Practice Address - Fax:901-765-3241
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000392492085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS302I302104Medicare PIN
TN103I309239Medicare PIN