Provider Demographics
NPI:1649247966
Name:MAGUIRE, JAMES KIMBRO JR (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:KIMBRO
Last Name:MAGUIRE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:260 FORT SANDERS WEST BLVD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-3355
Mailing Address - Country:US
Mailing Address - Phone:865-769-4500
Mailing Address - Fax:865-769-4557
Practice Address - Street 1:260 FORT SANDERS WEST BLVD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-3355
Practice Address - Country:US
Practice Address - Phone:865-558-4400
Practice Address - Fax:865-769-4536
Is Sole Proprietor?:No
Enumeration Date:2006-03-06
Last Update Date:2017-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN15527207XS0117X
TNMD15527207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN200029525OtherRAILROAD MEDICARE
TN3071384OtherBLUE CROSS BLUE SHIELD
TN3009098Medicaid
TNTN0146OtherJOHN DEERE HEALTHCARE
TN4458538OtherAETNA
TN1195372OtherUNITED HEALTH CARE
TNTN0121OtherJOHN DEERE HEALTHCARE
TN100010625OtherTENNCARE
3009098Medicare ID - Type Unspecified
TN4458538OtherAETNA
TN1195372OtherUNITED HEALTH CARE
TN3071384OtherBLUE CROSS BLUE SHIELD