Healthcare Provider Details

I. General information

NPI: 1235133257
Provider Name (Legal Business Name): JAMES E CAIN JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2005
Last Update Date: 07/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 WEST RIVER WOODS PARKWAY SUITE 130
GLENDALE WI
53212
US

IV. Provider business mailing address

525 WEST RIVER WOODS PARKWAY SUITE 130
GLENDALE WI
53212-1058
US

V. Phone/Fax

Practice location:
  • Phone: 414-961-0304
  • Fax: 414-961-2061
Mailing address:
  • Phone: 414-961-0304
  • Fax: 414-961-2061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number33238
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number33238
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number7792214-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: