MEDICARE: MARK S. JAMES MS, CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SP-774	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023194362
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK S. JAMES MS, CCC-SLP

Provider Business Mailing Address
First Line	:	9850 S MARYLAND PKWY
Second Line	:	STE A-5 #469
City	:	LAS VEGAS
State	:	NV
Zip	:	89183-7146
Country	:	US
Telephone Number	:	702-401-4017
Fax Number	:	702-616-2526

Provider Business Practice Location Address
First Line	:	9850 S MARYLAND PKWY
Second Line	:	STE A-5 #469
City	:	LAS VEGAS
State	:	NV
Zip	:	89183-7146
Country	:	US
Telephone Number	:	702-401-4017
Fax Number	:	702-616-2526

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/30/2006
Last Update Date	:	05/23/2013

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