Provider Demographics
NPI:1871542233
Name:PROFFITT, JAMES DAVID JR (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DAVID
Last Name:PROFFITT
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:1225 E WEISGARBER RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-2604
Mailing Address - Country:US
Mailing Address - Phone:865-584-4747
Mailing Address - Fax:865-584-1363
Practice Address - Street 1:701 MORGANTON SQUARE DR
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37801-4796
Practice Address - Country:US
Practice Address - Phone:865-984-6823
Practice Address - Fax:865-984-0824
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2018-12-11
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Provider Licenses
StateLicense IDTaxonomies
TN25052207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3714826OtherMEDICARE GROUP
TN3080090Medicare PIN
TN3714826OtherMEDICARE GROUP