Healthcare Provider Details

I. General information

NPI: 1780655704
Provider Name (Legal Business Name): JAMES WARD FOLLETTE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/28/2006
Last Update Date: 04/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 SENECA AVE
ONEIDA NY
13421-2555
US

IV. Provider business mailing address

13 SENECA AVE
ONEIDA NY
13421-2555
US

V. Phone/Fax

Practice location:
  • Phone: 315-280-0363
  • Fax: 315-280-0579
Mailing address:
  • Phone: 315-280-0363
  • Fax: 315-280-0579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LA0401X
TaxonomyAddiction Medicine (Anesthesiology) Physician
License Number144544
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: