Provider Demographics
NPI:1447251269
Name:MASTERS, JAMES E (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:E
Last Name:MASTERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4105 FORT HENRY DR
Mailing Address - Street 2:SUITE 207
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37663-2240
Mailing Address - Country:US
Mailing Address - Phone:423-239-5833
Mailing Address - Fax:423-239-9789
Practice Address - Street 1:4105 FORT HENRY DR
Practice Address - Street 2:SUITE 207
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37663-2240
Practice Address - Country:US
Practice Address - Phone:423-239-5833
Practice Address - Fax:423-239-9789
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-02
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN21759207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5701660Medicaid
KY64918279OtherKY MEDICAID
TN0100OtherJOHN DEERE
00013859OtherNHC CARE ADMINISTRATORS
086645OtherANTHEM BCBS
TN100010702Medicaid
WV0209517000Medicaid
3045886OtherBLUE SHIELD OF TN
NC890574WMedicaid
TN3081533Medicaid
WV0209517000Medicaid
NC890574WMedicaid
3045886OtherBLUE SHIELD OF TN