Provider Demographics
NPI:1235692468
Name:JAMES, ERIC (OD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:JAMES
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3303 ALPINE AVE NW STE A
Mailing Address - Street 2:
Mailing Address - City:WALKER
Mailing Address - State:MI
Mailing Address - Zip Code:49544-1605
Mailing Address - Country:US
Mailing Address - Phone:616-649-4703
Mailing Address - Fax:
Practice Address - Street 1:3303 ALPINE AVE NW STE A
Practice Address - Street 2:
Practice Address - City:WALKER
Practice Address - State:MI
Practice Address - Zip Code:49544-1605
Practice Address - Country:US
Practice Address - Phone:616-649-4703
Practice Address - Fax:616-784-2634
Is Sole Proprietor?:No
Enumeration Date:2019-04-14
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901005373152W00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes152W00000XEye and Vision Services ProvidersOptometrist