Provider Demographics
NPI:1144390972
Name:GADDY, JAMES B (MD)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:B
Last Name:GADDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2808
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99220
Mailing Address - Country:US
Mailing Address - Phone:509-688-6702
Mailing Address - Fax:509-688-6792
Practice Address - Street 1:910 W 5TH AVE
Practice Address - Street 2:STE 600
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2966
Practice Address - Country:US
Practice Address - Phone:509-455-9800
Practice Address - Fax:509-455-6913
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00015328207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAA07191Medicare UPIN