Provider Demographics
NPI:1225202484
Name:JAMES, JEFFREY NELSON (MD, DDS, FACS)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:NELSON
Last Name:JAMES
Suffix:
Gender:M
Credentials:MD, DDS, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 JOHN WESLEY GILBERT DRIVE GC 1168
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30912-1270
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1430 JOHN WESLEY GILBERT DRIVE
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30912-5536
Practice Address - Country:US
Practice Address - Phone:706-721-9744
Practice Address - Fax:706-721-6778
Is Sole Proprietor?:No
Enumeration Date:2008-04-18
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME119237204E00000X
GADNGA000670204E00000X
GA79392204E00000X
NC2018-02491208600000X
GADN015554204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003200149DMedicaid
SCZX9392Medicaid