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Individual

DR. JAMES J MACCARONE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
751 CHESAPEAKE LN, SUITE 101, CLARKSVILLE, TN 37040-5263
(931) 648-0202
(931) 648-0252
Mailing address
PO BOX 3540, CLARKSVILLE, TN 37043-3540
(931) 648-0202
(931) 648-0252

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
DO1235
TN
208VP0000X
Pain Medicine Physician
00000260
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
110204333
RAILROAD MEDICARE
TN
01
179292
ANTHEM BC/BS
TN
01
3144330
BLUE CROSS/BLUE SHIELD
TN
05
3305160
TN
Enumeration date
09/20/2006
Last updated
06/19/2015
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