Provider Demographics
NPI:1205859717
Name:SHORT, JAMES H (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:H
Last Name:SHORT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:P.O BOX 72384
Mailing Address - Street 2:RADIOLOGY ASSOCIATES OF CANTON, INC.
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44192
Mailing Address - Country:US
Mailing Address - Phone:888-686-1837
Mailing Address - Fax:330-686-5928
Practice Address - Street 1:2600 6TH ST SW
Practice Address - Street 2:RADIOLOGY ASSOCIATES OF CANTON, INC
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44710-1702
Practice Address - Country:US
Practice Address - Phone:330-363-2842
Practice Address - Fax:330-580-5536
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2011-01-05
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Provider Licenses
StateLicense IDTaxonomies
MN1025372085B0100X, 2085R0202X
OH35.0931522085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2997235Medicaid
OH2997235Medicaid