Healthcare Provider Details

I. General information

NPI: 1528049129
Provider Name (Legal Business Name): CHRIS JAMES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 07/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

576 JEFFERSON AVE. URGENT CARE CLINIC
FT. EUSTIS VA
23604-5548
US

IV. Provider business mailing address

1024 PORTE HARBOUR ARCH UNIT 301
HAMPTON VA
23664-1555
US

V. Phone/Fax

Practice location:
  • Phone: 757-314-7990
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101057963
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: