Provider Demographics
NPI:1194716506
Name:NORTHINGTON, JAMES WRIGHT (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:WRIGHT
Last Name:NORTHINGTON
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 1:1945 FLORENCE BLVD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-2729
Mailing Address - Country:US
Mailing Address - Phone:256-767-6293
Mailing Address - Fax:256-767-0492
Practice Address - Street 1:1945 FLORENCE BLVD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-2729
Practice Address - Country:US
Practice Address - Phone:256-767-6293
Practice Address - Fax:256-767-0492
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-03
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00007720174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL10497OtherPROVIDER ID #
AL051010497OtherBCBS ID #
AL630875014OtherTAX ID #
ALC75688Medicare UPIN
AL630875014OtherTAX ID #