Healthcare Provider Details

I. General information

NPI: 1265471544
Provider Name (Legal Business Name): DAVID LEE JAMES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905 JODE RD
AUDUBON PA
19403-1933
US

IV. Provider business mailing address

905 JODE RD
AUDUBON PA
19403-1933
US

V. Phone/Fax

Practice location:
  • Phone: 610-666-5944
  • Fax:
Mailing address:
  • Phone: 610-666-5944
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberMD12696
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: