Provider Demographics
NPI:1992064497
Name:MASKILL, JAMES
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:MASKILL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 NILES RD STE 9
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MI
Mailing Address - Zip Code:49085-3268
Mailing Address - Country:US
Mailing Address - Phone:616-340-3020
Mailing Address - Fax:
Practice Address - Street 1:2500 NILES RD STE 9
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-3268
Practice Address - Country:US
Practice Address - Phone:616-340-3020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-03
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAEL1890213ES0103X
MI5901002580213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery