Healthcare Provider Details

I. General information

NPI: 1023064490
Provider Name (Legal Business Name): JAMES G PAIRMORE PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 02/06/2024
Certification Date: 02/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E HOSPITAL RD
FT. EISENHOWER GA
30905
US

IV. Provider business mailing address

300 E HOSPITAL RD
FT EISENHOWER GA
30905
US

V. Phone/Fax

Practice location:
  • Phone: 67-787-0300
  • Fax:
Mailing address:
  • Phone: 706-787-0300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number004571
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: