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NPI Code Detail

MEDICARE: JAMES C COUCH III M.D.

MEDICARE: JAMES C COUCH III 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 Physician26082TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14022000OTHERTNBCBSTN
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1376635052
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES C COUCH III M.D.
Provider Business Mailing Address
First Line : 854 W JAMES CAMPBELL BLVD
Second Line : SUITE 303
City : COLUMBIA
State : TN
Zip : 38401-4659
Country : US
Telephone Number : 931-540-4255
Fax Number : 931-379-5867
Provider Business Practice Location Address
First Line : 200 S CROSS BRIDGES RD
Second Line :
City : MT PLEASANT
State : TN
Zip : 38474-1714
Country : US
Telephone Number : 931-379-5821
Fax Number : 931-379-5867
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2006
Last Update Date : 10/04/2010

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