MEDICARE: DR. LATONYA JAMES M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	053762	GA
2	207Q00000X	Family Medicine Physician	30553	AL

General Provider Information

NPI Number	:	1447241856
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LATONYA JAMES M.D

Provider Business Mailing Address
First Line	:	2305 HAND AVE
Second Line	:	3
City	:	BAY MINETTE
State	:	AL
Zip	:	36507-4191
Country	:	US
Telephone Number	:	251-937-1528
Fax Number	:	251-937-1529

Provider Business Practice Location Address
First Line	:	2305 HAND AVE
Second Line	:	3
City	:	BAY MINETTE
State	:	AL
Zip	:	36507-4191
Country	:	US
Telephone Number	:	251-937-1528
Fax Number	:	251-937-1529

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2005
Last Update Date	:	11/15/2010

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