Healthcare Provider Details

I. General information

NPI: 1245361054
Provider Name (Legal Business Name): JAMES WILBUR NESS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380 DUNN RD
TELLICO PLAINS TN
37385-5312
US

IV. Provider business mailing address

380 DUNN RD
TELLICO PLAINS TN
37385-5312
US

V. Phone/Fax

Practice location:
  • Phone: 423-253-7408
  • Fax: 423-253-7408
Mailing address:
  • Phone: 423-253-7408
  • Fax: 423-253-7408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberMD0000011169
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: