Healthcare Provider Details

I. General information

NPI: 1801878905
Provider Name (Legal Business Name): JAMES O FORDICE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2005
Last Update Date: 03/01/2023
Certification Date: 03/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1370 GATEWAY BLVD. SUITE 100
MURFREESBORO TN
37129-2590
US

IV. Provider business mailing address

3024 BUSINESS PARK CIR
GOODLETTSVILLE TN
37072-3132
US

V. Phone/Fax

Practice location:
  • Phone: 615-848-9265
  • Fax: 615-895-2155
Mailing address:
  • Phone: 615-239-2018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberJ3308
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number30184
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: