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General NPI Number Information
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NPI Number | 1013993443
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Entity Type | Individual
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Provider Name | JAMES BRUCE CARR II PA-C
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Gender | Male
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Dates
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Enumeration Date | 12/18/2005
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Last Update Date | 01/31/2023
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Provider Practice Location Address
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Address Line | 2300 E PARHAM RD
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City | RICHMOND
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State | VA
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Zip | 23228-3118
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Country | US
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Telephone | 804-264-7808
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Fax |
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Provider Business Mailing Address
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Address Line | 46041 W BELLE AVENUE
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City | MARICOPA
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State | AZ
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Zip | 85239
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Country | US
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Telephone | 520-868-8443
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Fax | 520-868-1547
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0110004183
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License Number State | VA
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