Provider Demographics
NPI:1154390649
Name:SHIRK, JAMES O (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:O
Last Name:SHIRK
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 1:1930 ALCOA HWY STE 240
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1510
Mailing Address - Country:US
Mailing Address - Phone:865-546-1642
Mailing Address - Fax:865-305-6195
Practice Address - Street 1:1930 ALCOA HWY STE 240
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1510
Practice Address - Country:US
Practice Address - Phone:865-546-1642
Practice Address - Fax:865-305-6195
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN25443207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ007732Medicaid
TN3083659Medicaid
TN3373353Medicare PIN
TN3083653Medicare PIN