Provider Demographics
NPI:1215443387
Name:SOLEN, JAMES MAC JR
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:MAC
Last Name:SOLEN
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:732 OLD WATERMELON RD
Mailing Address - Street 2:
Mailing Address - City:TENNILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31089-5544
Mailing Address - Country:US
Mailing Address - Phone:478-231-5055
Mailing Address - Fax:
Practice Address - Street 1:1826 VETERANS BLVD
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-3620
Practice Address - Country:US
Practice Address - Phone:478-272-1210
Practice Address - Fax:478-274-5511
Is Sole Proprietor?:No
Enumeration Date:2017-12-27
Last Update Date:2017-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN186048363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARN186048OtherSTATE LICENSE NUMBER