Provider Demographics
NPI:1225023823
Name:GENTRY, JAMES HOWARD JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:HOWARD
Last Name:GENTRY
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:1400B CARROLLTON RD
Mailing Address - Street 2:
Mailing Address - City:ALICEVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35442
Mailing Address - Country:US
Mailing Address - Phone:205-373-2229
Mailing Address - Fax:205-373-3779
Practice Address - Street 1:1400B CARROLLTON RD
Practice Address - Street 2:
Practice Address - City:ALICEVILLE
Practice Address - State:AL
Practice Address - Zip Code:35442
Practice Address - Country:US
Practice Address - Phone:205-373-2229
Practice Address - Fax:205-373-3779
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL9753208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51014623OtherBLUE CROSS BLUE SHIELD
AL51014623OtherBLUE CROSS BLUE SHIELD