MEDICARE: JAMES C LATHROP MD

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
1	208600000X	Surgery Physician	JL044836	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	044836	OTHER	MI	BLUE CROSS

General Provider Information

NPI Number	:	1326030602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES C LATHROP MD

Provider Business Mailing Address
First Line	:	1255 E COLLEGE ST STE 500
Second Line	:
City	:	PULASKI
State	:	TN
Zip	:	38478-4562
Country	:	US
Telephone Number	:	931-363-8055
Fax Number	:	931-363-8056

Provider Business Practice Location Address
First Line	:	1255 E COLLEGE ST STE 500
Second Line	:
City	:	PULASKI
State	:	TN
Zip	:	38478-4562
Country	:	US
Telephone Number	:	931-363-8055
Fax Number	:	931-363-8056

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2005
Last Update Date	:	10/07/2011

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Directions to “ JAMES C LATHROP MD” Practice Location

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