Provider Demographics
NPI:1811938160
Name:DAVIS, JAMES WILLIAMS (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:WILLIAMS
Last Name:DAVIS
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 1:140 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-1726
Mailing Address - Country:US
Mailing Address - Phone:931-783-5582
Mailing Address - Fax:931-526-6760
Practice Address - Street 1:100 W 4TH ST
Practice Address - Street 2:SUITE 350
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-2448
Practice Address - Country:US
Practice Address - Phone:931-783-2753
Practice Address - Fax:931-783-2036
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN27909207RS0012X, 207RS0012X
KYTP957207RS0012X
KY40828207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN6032705OtherBCBS
TNQ010473Medicaid
KY64923972Medicaid
KY0935375Medicare PIN
B05175Medicare UPIN