Healthcare Provider Details

I. General information

NPI: 1568514313
Provider Name (Legal Business Name): JAMES N. RILEY, D.O., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 SOUTH MAIN ST
BREWER ME
04412-2326
US

IV. Provider business mailing address

451 SOUTH MAIN ST
BREWER ME
04412-2326
US

V. Phone/Fax

Practice location:
  • Phone: 207-989-1567
  • Fax: 207-989-6889
Mailing address:
  • Phone: 207-989-1567
  • Fax: 207-989-6889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number1170
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number1170
License Number StateME
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number016622
License Number StateME

VIII. Authorized Official

Name: DR. JAMES N RILEY SR.
Title or Position: PRESIDENT
Credential: D.O.
Phone: 207-989-1567