Individual
JAMES W SHORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
117 KENNEDY DR, MARTIN, TN 38237-3394
(731) 587-9511
(877) 309-6416
Mailing address
117 KENNEDY DR, MARTIN, TN 38237-3309
(731) 587-9511
(877) 309-6416
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD5113
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3005840
BLUE CROSS BLUE SHIELD
TN
05
—
3144167
—
TN
01
—
4482791
AETNA
—
01
—
712671
WELLCARE
—
Enumeration date
07/18/2005
Last updated
05/26/2021
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