Healthcare Provider Details
I. General information
NPI: 1043386931
Provider Name (Legal Business Name): JAMES E MCCABE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/24/2006
Last Update Date: 08/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2996 7TH AVE STE B
MARION IA
52302-3713
US
IV. Provider business mailing address
2996 7TH AVE STE B
MARION IA
52302-3713
US
V. Phone/Fax
- Phone: 319-377-4844
- Fax: 319-377-0852
- Phone: 319-377-4844
- Fax: 319-377-0852
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 20629 |
| License Number State | IA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: