MEDICARE: DR. LARRY GENE JAMES D.M.D

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	1223G0001X	General Practice Dentistry	DN 9512	FL

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	:	1154436129
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LARRY GENE JAMES D.M.D

Provider Business Mailing Address
First Line	:	4100 SOUTH HOSPITAL DRIVE
Second Line	:	SUITE 208
City	:	PLANTATION
State	:	FL
Zip	:	33317-0208
Country	:	US
Telephone Number	:	954-791-6700
Fax Number	:	954-797-7622

Provider Business Practice Location Address
First Line	:	4100 S HOSPITAL DR
Second Line	:	SUITE 208
City	:	PLANTATION
State	:	FL
Zip	:	33317-2813
Country	:	US
Telephone Number	:	954-791-6700
Fax Number	:	954-797-7622

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

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	07/09/2007

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