Provider Demographics
NPI:1003806209
Name:ANTHONY, JAMES M (MD)
Entity Type:Individual
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First Name:JAMES
Middle Name:M
Last Name:ANTHONY
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1800 LIVINGSTON AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44052-3781
Mailing Address - Country:US
Mailing Address - Phone:440-233-1068
Mailing Address - Fax:440-233-1028
Practice Address - Street 1:1957 COOPER FOSTER PARK RD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:OH
Practice Address - Zip Code:44001-1207
Practice Address - Country:US
Practice Address - Phone:440-233-1068
Practice Address - Fax:440-246-4560
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2022-01-20
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Provider Licenses
StateLicense IDTaxonomies
OH350452752083X0100X, 207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0487647Medicaid