Provider Demographics
NPI:1043331382
Name:DURHAM, JAMES HARVEY
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:HARVEY
Last Name:DURHAM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:552 GLEN ABERNATHY RD
Mailing Address - Street 2:
Mailing Address - City:ADAMSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38310-1704
Mailing Address - Country:US
Mailing Address - Phone:731-607-6022
Mailing Address - Fax:731-632-9814
Practice Address - Street 1:106 ASH STREET
Practice Address - Street 2:SUITE II
Practice Address - City:ADAMSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38310
Practice Address - Country:US
Practice Address - Phone:731-201-3430
Practice Address - Fax:866-430-7946
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1454981332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0471410001Medicare NSC