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NPI Code Detail

MEDICARE: JAMES B WEST PA-C

MEDICARE: JAMES B WEST 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
1363A00000XPhysician Assistant5325TN
2363A00000XPhysician AssistantPA1080KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
112007739OTHERCAQH
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1689807182
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES B WEST PA-C
Provider Business Mailing Address
First Line : PO BOX 690
Second Line :
City : BEATTYVILLE
State : KY
Zip : 41311-0690
Country : US
Telephone Number : 606-464-2401
Fax Number : 606-464-3290
Provider Business Practice Location Address
First Line : 1484 LAKESIDE DR
Second Line :
City : JACKSON
State : KY
Zip : 41339-6555
Country : US
Telephone Number : 606-666-9950
Fax Number : 606-666-9136
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2009
Last Update Date : 05/12/2023

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