Basic Information
| Provider Information | |||||||||
| NPI: | 1396701439 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | O'TOOLE | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 66 N PAULINE ST | ||||||||
| Address2: | SUITE 206 | ||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381055105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9014487642 | ||||||||
| FaxNumber: | 9014488015 | ||||||||
| Practice Location | |||||||||
| Address1: | 1910 NONCONNAH BLVD | ||||||||
| Address2: | SUITE 120 | ||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381322113 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9014482300 | ||||||||
| FaxNumber: | 9014486657 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/26/2006 | ||||||||
| LastUpdateDate: | 09/26/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 37107 | TN | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | ME135702 | FL | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 3889382 | 05 | TN | MEDICAID |