Healthcare Provider Details

I. General information

NPI: 1225113210
Provider Name (Legal Business Name): FREDERICK MARTIN JAMES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2260 WRIGHTSBORO RD
AUGUSTA GA
30904-4764
US

IV. Provider business mailing address

1499 WALTON WAY SUITE 1400
AUGUSTA GA
30901-2602
US

V. Phone/Fax

Practice location:
  • Phone: 706-721-7951
  • Fax:
Mailing address:
  • Phone: 706-724-6100
  • Fax: 706-724-1600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number14208
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number14208
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number040929
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: