MEDICARE: DR. JAMES MICHAEL NANNEY 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
1	207P00000X	Emergency Medicine Physician	11576	MS
2	207Q00000X	Family Medicine Physician	11576	MS

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	730-09441	OTHER		BLUE CROSS OF AL

General Provider Information

NPI Number	:	1932181740
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES MICHAEL NANNEY M.D.

Provider Business Mailing Address
First Line	:	PO BOX 5183
Second Line	:
City	:	MERIDIAN
State	:	MS
Zip	:	39302-5183
Country	:	US
Telephone Number	:	601-703-9506
Fax Number	:	601-703-3264

Provider Business Practice Location Address
First Line	:	2800 N HILLS ST
Second Line	:
City	:	MERIDIAN
State	:	MS
Zip	:	39305-2643
Country	:	US
Telephone Number	:	601-693-9906
Fax Number	:	601-484-6704

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

Provider Enumeration Date	:	11/17/2005
Last Update Date	:	06/20/2008

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Directions to “ DR. JAMES MICHAEL NANNEY M.D.” Practice Location

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