Provider Demographics
NPI:1154513570
Name:BOES, JAMES J (DO)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:J
Last Name:BOES
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:500 LAKE SHORE DR
Mailing Address - Street 2:
Mailing Address - City:ESCANABA
Mailing Address - State:MI
Mailing Address - Zip Code:49829-3922
Mailing Address - Country:US
Mailing Address - Phone:906-789-7076
Mailing Address - Fax:906-789-4490
Practice Address - Street 1:3409 LUDINGTON ST
Practice Address - Street 2:SUITE 200
Practice Address - City:ESCANABA
Practice Address - State:MI
Practice Address - Zip Code:49829-4212
Practice Address - Country:US
Practice Address - Phone:906-786-7600
Practice Address - Fax:906-789-4490
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-10
Last Update Date:2007-08-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5101012421207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP09100001Medicare PIN