Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | DC 162 | VA |
Y | 111N00000X | Chiropractor | DC 163 | TN |
N | 111N00000X | Chiropractor | DC 2510 | SC |
NPI | 1003819483 |
---|---|
Provider Name | Dr. James Erby Messimer |
First Address | Bristol, TN 37620-3640 |
Second Address | Bristol, TN 37620-3640 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2005 |
Last Update Date | 26/11/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00014535 | BCBSTN NUMBER (01) | TN |
0101 | JOHN DEERE ID NUMBER (01) | TN |
3678217 | MEDICARE GROUP NUMBER (01) | TN |
391886617 | TRIAD PIN (01) | TN |
770005 | BCBSVA PIN (01) | VA |
T74471 | (02) | TN |