MEDICARE: JAMES THURMAN JAKES MD

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	207RR0500X	Rheumatology Physician	10168	AL

General Provider Information

NPI Number	:	1578547352
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES THURMAN JAKES MD

Provider Business Mailing Address
First Line	:	2015 2ND AVE STE 204
Second Line	:
City	:	SUMMERVILLE
State	:	SC
Zip	:	29486-7889
Country	:	US
Telephone Number	:	334-284-3105
Fax Number	:	334-284-3107

Provider Business Practice Location Address
First Line	:	1421 NARROW LANE PKWY
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36111-2654
Country	:	US
Telephone Number	:	334-284-3105
Fax Number	:	334-284-3107

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

Provider Enumeration Date	:	12/05/2005
Last Update Date	:	05/08/2024

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