Provider Demographics
NPI:1871811612
Name:BEKENY, JAMES RUSSELL (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:RUSSELL
Last Name:BEKENY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 24TH AVE N STE 120
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1505
Mailing Address - Country:US
Mailing Address - Phone:615-342-0290
Mailing Address - Fax:615-342-0289
Practice Address - Street 1:335 24TH AVE N STE 120
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1505
Practice Address - Country:US
Practice Address - Phone:615-342-0290
Practice Address - Fax:615-342-0289
Is Sole Proprietor?:No
Enumeration Date:2010-05-04
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.126440207Y00000X
FLME128330207Y00000X, 207YX0905X
TN65754207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery