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General NPI Number Information
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NPI Number | 1225561194
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Entity Type | Individual
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Provider Name | JAMES GREGORY LAVERY M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/07/2017
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 2141 LAKE AVE
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City | ASHTABULA
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State | OH
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Zip | 44004-3435
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Country | US
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Telephone | 440-443-0442
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Fax | 440-755-8010
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Provider Business Mailing Address
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Address Line | 29111 CEDAR RD
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City | MAYFIELD HEIGHTS
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State | OH
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Zip | 44124-4005
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Country | US
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Telephone | 440-646-1600
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Fax | 440-646-1505
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35.137506
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 35.137506
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License Number State | OH
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