Healthcare Provider Details

I. General information

NPI: 1124078647
Provider Name (Legal Business Name): JAMES PORTERFIELD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 08/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 UNION AVE SUITE 475
MEMPHIS TN
38104-6638
US

IV. Provider business mailing address

PO BOX 357 DEPT 130
MEMPHIS TN
38150-0001
US

V. Phone/Fax

Practice location:
  • Phone: 901-274-2643
  • Fax: 901-726-4237
Mailing address:
  • Phone: 901-274-2643
  • Fax: 901-726-4237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberMD0000009332
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: