Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | MD-26376 | TN |
NPI | 1003005885 |
---|---|
Provider Name | Dr. James H Jaster |
First Address | Memphis, TN 38104-3121 |
Second Address | Memphis, TN 38104-3121 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2007 |
Last Update Date | 04/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1510855 | (05) | TN |
1811816 | (05) | TN |
3032118 | BLUE CROSS BLUE SHIELD (01) | TN |
4173667 | BLUECROSS BLUESHIELD (01) | TN |
G23775 | (02) | TN |