Provider Demographics
NPI:1700239332
Name:JAMES, TIPHANI (DPM)
Entity type:Individual
Prefix:
First Name:TIPHANI
Middle Name:
Last Name:JAMES
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:TIPHANI
Other - Middle Name:
Other - Last Name:GRIMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:540 CHARTER BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-4894
Mailing Address - Country:US
Mailing Address - Phone:478-295-6381
Mailing Address - Fax:833-972-2508
Practice Address - Street 1:540 CHARTER BLVD STE 300
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-4894
Practice Address - Country:US
Practice Address - Phone:478-295-6381
Practice Address - Fax:833-972-2508
Is Sole Proprietor?:No
Enumeration Date:2016-07-19
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL135.000930213E00000X
IL016-005842213E00000X
GAPOD305051213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist