Healthcare Provider Details

I. General information

NPI: 1720817836
Provider Name (Legal Business Name): ANDREW J JAMES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2024
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 S JACKSON ST STE 710
LOUISVILLE KY
40202-1622
US

IV. Provider business mailing address

550 S JACKSON ST STE 710
LOUISVILLE KY
40202-1622
US

V. Phone/Fax

Practice location:
  • Phone: 502-583-8303
  • Fax:
Mailing address:
  • Phone: 502-583-8303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberR7609
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License NumberR7609
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: