Provider Demographics
NPI:1558189696
Name:JAMES FAMILY PRACTICE
Entity type:Organization
Organization Name:JAMES FAMILY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:DNP-FNP
Authorized Official - Phone:901-649-3648
Mailing Address - Street 1:2900 NW CLEARWATER DR STE 200-1004
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-9410
Mailing Address - Country:US
Mailing Address - Phone:541-940-8800
Mailing Address - Fax:541-314-9611
Practice Address - Street 1:2900 NW CLEARWATER DR STE 200-1004
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-9410
Practice Address - Country:US
Practice Address - Phone:541-940-8800
Practice Address - Fax:541-314-9611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-27
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care