Provider Demographics
NPI:1699039313
Name:WAHL, JAMES W (DO)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:W
Last Name:WAHL
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:100 GROSS CRESCENT CIR
Mailing Address - Street 2:
Mailing Address - City:FORT OGLETHORPE
Mailing Address - State:GA
Mailing Address - Zip Code:30742-3643
Mailing Address - Country:US
Mailing Address - Phone:706-858-2000
Mailing Address - Fax:706-858-2681
Practice Address - Street 1:100 GROSS CRESCENT CIR
Practice Address - Street 2:
Practice Address - City:FORT OGLETHORPE
Practice Address - State:GA
Practice Address - Zip Code:30742-3643
Practice Address - Country:US
Practice Address - Phone:706-858-2000
Practice Address - Fax:706-858-2681
Is Sole Proprietor?:No
Enumeration Date:2012-06-27
Last Update Date:2022-04-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA83444207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine