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General NPI Number Information
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NPI Number | 1558976407
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Entity Type | Individual
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Provider Name | JAMES L STALLWORTH JR. MD, PHARMD
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Gender | Male
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Dates
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Enumeration Date | 09/08/2020
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Last Update Date | 07/20/2025
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Provider Practice Location Address
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Address Line | 1500 E MEDICAL CENTER DR
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City | ANN ARBOR
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State | MI
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Zip | 48109-5000
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Country | US
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Telephone | 734-936-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 BROADWAY ST
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City | ANN ARBOR
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State | MI
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Zip | 48105-2980
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Country | US
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Telephone | 251-635-9197
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 21591
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 4351053799
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License Number State | MI
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