Healthcare Provider Details

I. General information

NPI: 1588661805
Provider Name (Legal Business Name): JAMES T HARGER PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2005
Last Update Date: 12/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 RALSTON AVE STE 102
DEFIANCE OH
43512-5311
US

IV. Provider business mailing address

1250 RALSTON AVE STE 102
DEFIANCE OH
43512-5311
US

V. Phone/Fax

Practice location:
  • Phone: 419-783-9699
  • Fax: 419-782-8062
Mailing address:
  • Phone: 419-783-9699
  • Fax: 419-782-8062

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number50002112
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: