Provider Demographics
NPI:1801878905
Name:FORDICE, JAMES O (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:O
Last Name:FORDICE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:3024 BUSINESS PARK CIR
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-3132
Mailing Address - Country:US
Mailing Address - Phone:615-239-2018
Mailing Address - Fax:
Practice Address - Street 1:1370 GATEWAY BLVD.
Practice Address - Street 2:SUITE 100
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-2590
Practice Address - Country:US
Practice Address - Phone:615-848-9265
Practice Address - Fax:615-895-2155
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ3308207Y00000X
TN30184207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN5845651OtherAETNA
KY6472060000Medicaid
TNTN137OtherAMERICHOICE
1071161OtherUSA MANAGED CARE
TN0987523OtherCIGNA
TN1343463OtherCOVENTRY/FIRST HEALTH
TN01158809OtherAMERIGROUP
TN12079238OtherMULTIPLAN/PHCS
TN38241311Medicaid
TN4165055OtherBCBS OF TN
TN924317OtherADVANTRA FREEDOM MEDICARE
TNP00477337OtherMEDICARE RR
TN1807323OtherUNITED HEALTH CARE
TN01158809OtherAMERIGROUP
G72278Medicare UPIN