Provider Demographics
NPI:1033271853
Name:CAGLE, JAMES W JR (DO)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:W
Last Name:CAGLE
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:PO BOX 80846
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99708-0846
Mailing Address - Country:US
Mailing Address - Phone:907-458-5178
Mailing Address - Fax:907-458-5180
Practice Address - Street 1:1650 COWLES ST
Practice Address - Street 2:SUITE 280 NT
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-5998
Practice Address - Country:US
Practice Address - Phone:907-458-5178
Practice Address - Fax:907-458-5180
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2012-01-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO46060207RC0200X, 207P00000X
AKAK 7044207P00000X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04594040Medicaid
AKK163347Medicaid
CO91356504Medicaid
CO91356504Medicaid
COCQ2008Medicare PIN