Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | MD034537E | PA |
NPI | 1003831306 |
---|---|
Provider Name | Dr. Roy Lewis James |
First Address | Lehighton, PA 18235-1401 |
Second Address | Salt Lake City, UT 84106-1887 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2006 |
Last Update Date | 08/07/2007 |