MEDICARE: JAMES RICHARD OLES PA-C

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	363AS0400X	Surgical Physician Assistant	102944	NC

General Provider Information

NPI Number	:	1538101340
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES RICHARD OLES PA-C

Provider Business Mailing Address
First Line	:	220 JEFFERSON ST
Second Line	:
City	:	WHITEVILLE
State	:	NC
Zip	:	28472-3416
Country	:	US
Telephone Number	:	910-642-3214
Fax Number	:	910-642-2085

Provider Business Practice Location Address
First Line	:	220 JEFFERSON ST
Second Line	:
City	:	WHITEVILLE
State	:	NC
Zip	:	28472-3416
Country	:	US
Telephone Number	:	910-642-3214
Fax Number	:	910-642-2085

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

Provider Enumeration Date	:	06/13/2006
Last Update Date	:	01/06/2010

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Directions to “ JAMES RICHARD OLES PA-C” Practice Location

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