Provider Demographics
NPI:1194449512
Name:JAMES, PEYTON
Entity type:Individual
Prefix:
First Name:PEYTON
Middle Name:
Last Name:JAMES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 DEESE ST
Mailing Address - Street 2:
Mailing Address - City:BEEBE
Mailing Address - State:AR
Mailing Address - Zip Code:72012-2050
Mailing Address - Country:US
Mailing Address - Phone:501-239-3353
Mailing Address - Fax:
Practice Address - Street 1:1001 DEESE ST
Practice Address - Street 2:
Practice Address - City:BEEBE
Practice Address - State:AR
Practice Address - Zip Code:72012-2050
Practice Address - Country:US
Practice Address - Phone:501-239-3353
Practice Address - Fax:501-232-5057
Is Sole Proprietor?:No
Enumeration Date:2022-09-29
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARPTA4402OtherPHYSICAL THERAPY LICENSE