Provider Demographics
NPI:1962418988
Name:LABRESH, JAMES CECIL (PA)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:CECIL
Last Name:LABRESH
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:701 UNIVERSITY BLVD E STE 808
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-7433
Mailing Address - Country:US
Mailing Address - Phone:205-759-5640
Mailing Address - Fax:205-759-5639
Practice Address - Street 1:701 UNIVERSITY BLVD E STE 808
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401-7433
Practice Address - Country:US
Practice Address - Phone:205-759-5640
Practice Address - Fax:205-759-5639
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-12-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ALPA-79363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-39606OtherBCBS OF AL
P00395581OtherRAILROAD MEDICARE PIN
ALR62034Medicare UPIN