Individual
JAMES W SHINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1901 S SHADY ST, MOUNTAIN CITY, TN 37683-2021
(423) 727-1103
(423) 727-1140
Mailing address
1901 S SHADY ST, MOUNTAIN CITY, TN 37683-2021
(423) 727-1103
(423) 727-1140
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD28372
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1194781724
—
VA
05
—
3803906
—
TN
01
—
4062642
BCBS
TN
05
—
Q009917
—
TN
01
—
TN0167
JOHN DEERE
TN
Enumeration date
04/22/2006
Last updated
02/23/2017
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