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General NPI Number Information
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NPI Number | 1932106549
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Entity Type | Individual
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Provider Name | JAMES J HANOSH JR. MD
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Gender | Male
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Dates
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Enumeration Date | 06/29/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2440 N 11TH ST
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City | GRAND JUNCTION
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State | CO
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Zip | 81501-8102
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Country | US
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Telephone | 970-243-0900
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Fax |
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Provider Business Mailing Address
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Address Line | 501 AIRPORT RD
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City | RIFLE
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State | CO
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Zip | 81650-8510
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Country | US
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Telephone | 970-243-0900
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 33975
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License Number State | CO
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