Provider Demographics
NPI:1700137627
Name:STEDMAN, JAMES E (DPH)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:E
Last Name:STEDMAN
Suffix:
Gender:M
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1089 COWAN RD
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-3409
Mailing Address - Country:US
Mailing Address - Phone:615-973-6560
Mailing Address - Fax:615-446-6578
Practice Address - Street 1:1089 COWAN RD
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-3409
Practice Address - Country:US
Practice Address - Phone:615-973-6560
Practice Address - Fax:615-446-6578
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-02
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2988183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist