Provider Demographics
NPI:1104894526
Name:SENTER, JAMES PARKER (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:PARKER
Last Name:SENTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7523 DC CANEY RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:COEBURN
Mailing Address - State:VA
Mailing Address - Zip Code:24230-4936
Mailing Address - Country:US
Mailing Address - Phone:276-835-9731
Mailing Address - Fax:276-926-4782
Practice Address - Street 1:7523 DC CANEY RIDGE RD
Practice Address - Street 2:
Practice Address - City:COEBURN
Practice Address - State:VA
Practice Address - Zip Code:24230-4936
Practice Address - Country:US
Practice Address - Phone:276-835-9731
Practice Address - Fax:276-835-1007
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-10
Last Update Date:2011-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101032888207Q00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA051019191013Medicaid
080007627OtherMEDICARE-TRAILBLAZER
VA1104894526Medicaid
493812OtherMEDICARE-RHC
VA007653387OtherMEDICAID-RHC
VA1104894526Medicaid
VA051019191013Medicaid