Provider Demographics
NPI:1083146922
Name:LEPAGE, JAMES ROBERT JR (DO)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ROBERT
Last Name:LEPAGE
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1015 MONTLIMAR DR STE A210
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-1743
Mailing Address - Country:US
Mailing Address - Phone:251-461-4243
Mailing Address - Fax:251-450-4323
Practice Address - Street 1:1015 MONTLIMAR DR STE A210
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-1743
Practice Address - Country:US
Practice Address - Phone:251-461-4243
Practice Address - Fax:251-450-4323
Is Sole Proprietor?:No
Enumeration Date:2017-03-30
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
ALDO.19382084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program