Provider Demographics
NPI:1962531384
Name:MARLOW, JAMES RUSSELL (PA-C)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:RUSSELL
Last Name:MARLOW
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20506 WILLIAMSBURG DR
Mailing Address - Street 2:
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-7117
Mailing Address - Country:US
Mailing Address - Phone:907-694-6766
Mailing Address - Fax:
Practice Address - Street 1:800 CORDOVA ST
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-3717
Practice Address - Country:US
Practice Address - Phone:907-222-7612
Practice Address - Fax:907-222-6976
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK133363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical