Healthcare Provider Details

I. General information

NPI: 1982674123
Provider Name (Legal Business Name): PHILIP M JAMES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 06/27/2022
Certification Date: 06/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 HIGHLAND AVE
MADISON WI
53705-2274
US

IV. Provider business mailing address

3200 E CAMELBACK RD STE 250
PHOENIX AZ
85018-2311
US

V. Phone/Fax

Practice location:
  • Phone: 608-263-3301
  • Fax: 608-263-0530
Mailing address:
  • Phone: 602-933-1813
  • Fax: 602-933-1820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207SG0202X
TaxonomyClinical Biochemical Genetics Physician
License Number220472
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License Number220472
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code207SG0202X
TaxonomyClinical Biochemical Genetics Physician
License Number18516
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number220472
License Number StateMA
# 5
Primary TaxonomyY
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License Number22415-875
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: