Provider Demographics
NPI:1285944686
Name:GEORGE K JAMES MD FACS PA
Entity type:Organization
Organization Name:GEORGE K JAMES MD FACS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GEORGE K JAMES MD PRESIDENT
Authorized Official - Prefix:PROF
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:K
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-879-2277
Mailing Address - Street 1:4513 N ARMENIA AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33603-2703
Mailing Address - Country:US
Mailing Address - Phone:813-879-2277
Mailing Address - Fax:813-875-3363
Practice Address - Street 1:4513 N ARMENIA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-2703
Practice Address - Country:US
Practice Address - Phone:813-879-2277
Practice Address - Fax:813-875-3363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-19
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME25122261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL056564400Medicaid
FLD53783Medicare UPIN
FL29899Medicare PIN