Healthcare Provider Details

I. General information

NPI: 1114981560
Provider Name (Legal Business Name): JAMES ROY APPLETON III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 03/23/2022
Certification Date: 03/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

164 W UNIVERSITY PKWY STE A
JACKSON TN
38305-1621
US

IV. Provider business mailing address

18 GOLDEN POND CV
JACKSON TN
38305-7564
US

V. Phone/Fax

Practice location:
  • Phone: 731-215-1135
  • Fax: 731-410-6156
Mailing address:
  • Phone: 731-307-7312
  • Fax: 731-410-6156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number56098
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: