Healthcare Provider Details

I. General information

NPI: 1477948396
Provider Name (Legal Business Name): JAMES L FLANNERY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2015
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 WINDY PT
MARIETTA OH
45750-9209
US

IV. Provider business mailing address

101 WINDY PT
MARIETTA OH
45750-9209
US

V. Phone/Fax

Practice location:
  • Phone: --
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number72954
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: