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NPI Code Detail

MEDICARE: HEATHER R JAMES P.A.-C

MEDICARE: HEATHER R JAMES P.A.-C
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
1363A00000XPhysician Assistant1822WI

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00192602OTHERWIMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
114825OTHERWINETWORK HEALTH
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1922114347
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER R JAMES P.A.-C
Provider Business Mailing Address
First Line : PO BOX 735044
Second Line :
City : CHICAGO
State : IL
Zip : 60673-5044
Country : US
Telephone Number : 800-326-2250
Fax Number :
Provider Business Practice Location Address
First Line : 3400 UNION AVE
Second Line :
City : SHEBOYGAN
State : WI
Zip : 53081-8426
Country : US
Telephone Number : 920-828-2700
Fax Number : 920-828-2905
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2006
Last Update Date : 12/02/2024

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