Provider Demographics
NPI:1306138912
Name:ANGEL, JAMES BENJAMIN (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:BENJAMIN
Last Name:ANGEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:BEN
Other - Middle Name:
Other - Last Name:ANGEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1698 OLD LEBANON RD
Mailing Address - Street 2:STE 3B
Mailing Address - City:CAMPBELLSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42718-9662
Mailing Address - Country:US
Mailing Address - Phone:859-257-3533
Mailing Address - Fax:859-323-1944
Practice Address - Street 1:800 ROSE STREET
Practice Address - Street 2:UNIVERSITY OF KENTUCKY
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40505-0001
Practice Address - Country:US
Practice Address - Phone:859-257-3533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-15
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY49057208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology