Provider Demographics
NPI:1881788032
Name:YANDELL, JAMES ALLEN (OD)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ALLEN
Last Name:YANDELL
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:PO BOX 425
Mailing Address - Street 2:
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37744-0425
Mailing Address - Country:US
Mailing Address - Phone:423-638-4151
Mailing Address - Fax:423-639-6861
Practice Address - Street 1:1411 W MORRIS BLVD
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37813-2828
Practice Address - Country:US
Practice Address - Phone:423-587-3474
Practice Address - Fax:423-587-8735
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNODT1396152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN702006494OtherCARITEN
TN3137807OtherBLUECROSS BLUESHIELD
TN100022785OtherPHP
TN3137807Medicaid
TNP00332301OtherMEDICARE RAILROAD
TN3918780001Medicare NSC
TNP00332301OtherMEDICARE RAILROAD
TN3137807OtherBLUECROSS BLUESHIELD
TN35984402Medicare Oscar/Certification