Provider Demographics
NPI:1114973161
Name:PALEN, JAMES E (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:E
Last Name:PALEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3129 BLATTNER DR
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63703-6364
Mailing Address - Country:US
Mailing Address - Phone:573-335-0166
Mailing Address - Fax:573-335-7942
Practice Address - Street 1:3129 BLATTNER DR
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63703-6364
Practice Address - Country:US
Practice Address - Phone:573-335-0166
Practice Address - Fax:573-335-7942
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO32836207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO7362OtherBLUE CROSS BLUE SHIELD
MOA11875Medicare UPIN