Provider Demographics
NPI:1962566208
Name:JAMES W. FEELEY, III, M.D.
Entity type:Organization
Organization Name:JAMES W. FEELEY, III, M.D.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:FEELEY
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:540-743-9087
Mailing Address - Street 1:250 MEMORIAL DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:LURAY
Mailing Address - State:VA
Mailing Address - Zip Code:22835-1000
Mailing Address - Country:US
Mailing Address - Phone:540-743-9087
Mailing Address - Fax:540-743-1195
Practice Address - Street 1:250 MEMORIAL DR
Practice Address - Street 2:SUITE B
Practice Address - City:LURAY
Practice Address - State:VA
Practice Address - Zip Code:22835-1000
Practice Address - Country:US
Practice Address - Phone:540-743-9087
Practice Address - Fax:540-743-1195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA001158166363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005607850Medicaid
VA1649272147OtherNPI--JAMES FEELEY III MD
VA1730178773OtherNPI DEBORAH FORREST NP
VA005607850Medicaid
VA1730178773OtherNPI DEBORAH FORREST NP