Shine, James W

Shine, James W is an individual health care provider with primary practice located at 1901 S Shady St , Mountain City TN 37683-2021. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Shine, James W can be contacted via phone (423) 727-1103.

Contact Information

Primary practice address
1901 S Shady St Mountain City TN 37683-2021
Phone: (423) 727-1103
Fax: (423) 727-1140
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD28372 Tennessee

Profile Details

NPI number 1194781724
LBN Legal business name Shine, James W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 22nd, 2006
Last updated Feb 23rd, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194781724 NPPES
Tennessee MEDICAID 3803906
Tennessee MEDICAID Q009917
Tennessee Other TN0167
Tennessee MEDICAID 1194781724
Tennessee Other 4062642

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