Healthcare Provider Details

I. General information

NPI: 1629077326
Provider Name (Legal Business Name): JAMES D QUARLES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2005
Last Update Date: 11/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 C MICHAEL DAVENPORT BLVD. STE A.
FRANKFORT KY
40601-4399
US

IV. Provider business mailing address

80 C MICHAEL DAVENPORT BLVD. STE A.
FRANKFORT KY
40601-4399
US

V. Phone/Fax

Practice location:
  • Phone: 502-227-8681
  • Fax: 502-223-7046
Mailing address:
  • Phone: 502-227-8681
  • Fax: 502-223-7046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number37457
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code207RS0010X
TaxonomySports Medicine (Internal Medicine) Physician
License Number23513
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: