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NPI Code Detail

MEDICARE: DR. JAMES K TATUM M.D.

MEDICARE:  DR. JAMES K TATUM  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianMD035492EPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083647564
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMES K TATUM M.D.
Provider Business Mailing Address
First Line : 2299 BRODHEAD RD
Second Line :
City : ALIQUIPPA
State : PA
Zip : 15001-4674
Country : US
Telephone Number : 724-378-8484
Fax Number : 724-773-8966
Provider Business Practice Location Address
First Line : 2299 BRODHEAD RD
Second Line :
City : ALIQUIPPA
State : PA
Zip : 15001-4674
Country : US
Telephone Number : 724-378-8484
Fax Number : 724-773-8966
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2006
Last Update Date : 08/01/2019

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