Provider Demographics
NPI:1184852782
Name:JAMES H OURY MD MEDICAL CORPORATION
Entity Type:Organization
Organization Name:JAMES H OURY MD MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:H
Authorized Official - Last Name:OURY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:605-721-7723
Mailing Address - Street 1:607 1/2 MT RUSHMORE ROAD SUITE 112
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-4526
Mailing Address - Country:US
Mailing Address - Phone:605-721-7723
Mailing Address - Fax:
Practice Address - Street 1:607 1/2 MOUNT RUSHMORE RD STE 112
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-2782
Practice Address - Country:US
Practice Address - Phone:605-721-7723
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-23
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD4873208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty