Provider Demographics
NPI:1487471819
Name:CARRIGER, JAMES
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:CARRIGER
Suffix:
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 1:12647 N 113TH DR
Mailing Address - Street 2:
Mailing Address - City:YOUNGTOWN
Mailing Address - State:AZ
Mailing Address - Zip Code:85363-1128
Mailing Address - Country:US
Mailing Address - Phone:623-262-5057
Mailing Address - Fax:
Practice Address - Street 1:12647 N 113TH DR
Practice Address - Street 2:
Practice Address - City:YOUNGTOWN
Practice Address - State:AZ
Practice Address - Zip Code:85363-1128
Practice Address - Country:US
Practice Address - Phone:623-262-5057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-25
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172A00000X
AZD01084465172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver