Healthcare Provider Details

I. General information

NPI: 1285628800
Provider Name (Legal Business Name): JAMES CARNEY IRION MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2005
Last Update Date: 05/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1236 GUILFORD COLLEGE RD STE 117
JAMESTOWN NC
27282-9875
US

IV. Provider business mailing address

PO BOX 60447
CHARLOTTE NC
28260-0447
US

V. Phone/Fax

Practice location:
  • Phone: 336-856-0801
  • Fax: 336-856-2804
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number38094
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: