Provider Demographics
NPI:1841373727
Name:SLOAN, JAMES T (OD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:T
Last Name:SLOAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4678 KNIGHT ARNOLD ROAD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38118
Mailing Address - Country:US
Mailing Address - Phone:901-363-2001
Mailing Address - Fax:901-367-9355
Practice Address - Street 1:4678 KNIGHT ARNOLD RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38118
Practice Address - Country:US
Practice Address - Phone:901-363-2001
Practice Address - Fax:901-367-9355
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN0757152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1346392347OtherNPI
TN3595608Medicaid
TNQ008437Medicaid
TN1578615571OtherNPI
TN1134282163OtherNPI
TNQ008437Medicaid