Provider Demographics
NPI:1912960329
Name:NAGLE, JAMES BOYD (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:BOYD
Last Name:NAGLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 292558
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-0558
Mailing Address - Country:US
Mailing Address - Phone:937-293-5352
Mailing Address - Fax:937-293-5566
Practice Address - Street 1:200 TAIT RD
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-1125
Practice Address - Country:US
Practice Address - Phone:937-293-5352
Practice Address - Fax:937-885-1024
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35039117174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0312629Medicaid
OH000000188429OtherANTHEM
OH01-01391OtherUNITED HEALTHCARE
OH380001819OtherRAILROAD MEDICARE
OH01-02348OtherEVERCARE
OH31168736000OtherCAREWORKS
OH0312629Medicaid
OH0418167Medicare ID - Type Unspecified