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General NPI Number Information
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NPI Number | 1801156609
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Entity Type | Individual
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Provider Name | JENNIFER JAMES MD
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Gender | Female
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Dates
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Enumeration Date | 05/25/2012
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Last Update Date | 02/05/2024
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Provider Practice Location Address
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Address Line | 5606 SW LEE BLVD STE 303
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City | LAWTON
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State | OK
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Zip | 73505-9618
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Country | US
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Telephone | 580-531-6455
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 82
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City | SHANNON
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State | AL
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Zip | 35142-0082
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Country | US
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Telephone | 888-212-4243
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 29235
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License Number State | OK
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