Provider Demographics
NPI:1104802271
Name:BACHSTEIN, JAMES M (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:BACHSTEIN
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 1:112 BABB DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-2506
Mailing Address - Country:US
Mailing Address - Phone:615-466-0041
Mailing Address - Fax:615-466-0042
Practice Address - Street 1:112 BABB DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-2506
Practice Address - Country:US
Practice Address - Phone:615-466-0041
Practice Address - Fax:615-466-0042
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-20
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000026422207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4002648OtherBC/BS OF TN
TN3092275Medicaid
TN0140598OtherUHC
TN0678015OtherAETNA
TN3370236Medicaid
TN4691310-004OtherCIGNA
TN3370236Medicaid
TN0678015OtherAETNA
TN4691310-004OtherCIGNA
TN3092275Medicaid