Healthcare Provider Details

I. General information

NPI: 1609904432
Provider Name (Legal Business Name): JAMES DOYLE HELSLEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 04/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 RAYLOC DR
HANCOCK MD
21750-1518
US

IV. Provider business mailing address

109 RAYLOC DR
HANCOCK MD
21750-1518
US

V. Phone/Fax

Practice location:
  • Phone: 301-678-5187
  • Fax:
Mailing address:
  • Phone: 301-678-5187
  • Fax: 301-678-5797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD0074708
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: