Provider Demographics
NPI:1235137936
Name:FURICCHIA, JAMES VINCENT (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:VINCENT
Last Name:FURICCHIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3840 WOODLEY RD
Mailing Address - Street 2:UNIT A
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-1175
Mailing Address - Country:US
Mailing Address - Phone:419-729-8188
Mailing Address - Fax:419-729-8125
Practice Address - Street 1:3840 WOODLEY RD
Practice Address - Street 2:UNIT A
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-1175
Practice Address - Country:US
Practice Address - Phone:419-729-8188
Practice Address - Fax:419-729-8125
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35065100207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0935715Medicaid
F52690Medicare UPIN
OH0748625Medicare ID - Type Unspecified