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NPI Code Detail

MEDICARE: JAMES L DELINE M.D.

MEDICARE: JAMES L DELINE 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
1207Q00000XFamily Medicine PhysicianMD 36425MO
2207P00000XEmergency Medicine Physician36425MO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
6930078535OTHERRAILROAD MEDICARE
7010012805OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
154535OTHERUNITED HEALTHCARE
211794OTHERMOBLUE CROSS
3193025OTHERTHE FUNDS
4431671124DELOTHERMOMERCY HEALTH PLANS
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8252291OTHERHEALTHLINK HMO AND PPO
9MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1821091810
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES L DELINE M.D.
Provider Business Mailing Address
First Line : 307 MCKAY ST
Second Line :
City : MACON
State : MO
Zip : 63552-2029
Country : US
Telephone Number : 660-385-3141
Fax Number : 660-385-5866
Provider Business Practice Location Address
First Line : 307 MCKAY ST
Second Line :
City : MACON
State : MO
Zip : 63552-2029
Country : US
Telephone Number : 660-385-3141
Fax Number : 660-385-5866
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2005
Last Update Date : 11/13/2015

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Directions to “ JAMES L DELINE M.D.” Practice Location

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