Provider Demographics
NPI:1285793232
Name:JAMES, RAYMOND ALLEN (DO)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:ALLEN
Last Name:JAMES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3141 NW 63RD ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73116-3788
Mailing Address - Country:US
Mailing Address - Phone:405-607-1318
Mailing Address - Fax:405-607-1326
Practice Address - Street 1:21298 OLEAN BLVD
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-6705
Practice Address - Country:US
Practice Address - Phone:941-627-6130
Practice Address - Fax:941-627-6146
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS7168207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL57407OtherBLUE CROSS BLUE SHIELD
FL57407Medicare ID - Type Unspecified
F35067Medicare UPIN