Provider Demographics
NPI:1104895242
Name:ARD, JAMES GEORGE (DO)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:GEORGE
Last Name:ARD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:650 N PENROD RD # 707
Mailing Address - Street 2:
Mailing Address - City:SHOW LOW
Mailing Address - State:AZ
Mailing Address - Zip Code:85901-5284
Mailing Address - Country:US
Mailing Address - Phone:808-280-9539
Mailing Address - Fax:
Practice Address - Street 1:200 W HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:WHITERIVER
Practice Address - State:AZ
Practice Address - Zip Code:85941-0860
Practice Address - Country:US
Practice Address - Phone:928-338-4911
Practice Address - Fax:928-338-5508
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HIDOS-714207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000003228OtherHMSA BILLING NUMBER
AZ925065Medicaid
HI003970-02Medicaid
F46604Medicare UPIN
HI0000003228OtherHMSA BILLING NUMBER
AZ925065Medicaid