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NPI Code Detail

MEDICARE: JAMES RICHARD VENABLES

MEDICARE: JAMES RICHARD VENABLES
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
1175T00000XPeer Specialist

General Provider Information

NPI Number : 1598482606
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES RICHARD VENABLES
Provider Business Mailing Address
First Line : 3311 12TH ST NW
Second Line :
City : CANTON
State : OH
Zip : 44708-3909
Country : US
Telephone Number : 330-415-0630
Fax Number :
Provider Business Practice Location Address
First Line : 3311 12TH ST NW
Second Line :
City : CANTON
State : OH
Zip : 44708-3909
Country : US
Telephone Number : 330-415-0630
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2022
Last Update Date : 10/20/2022

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Directions to “ JAMES RICHARD VENABLES ” Practice Location

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