Provider Demographics
NPI:1285003095
Name:OVERLEY, JMES
Entity Type:Individual
Prefix:
First Name:JMES
Middle Name:
Last Name:OVERLEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2105 QUARRY CV
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72404-9122
Mailing Address - Country:US
Mailing Address - Phone:662-299-5630
Mailing Address - Fax:
Practice Address - Street 1:2105 QUARRY CV
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72404-9122
Practice Address - Country:US
Practice Address - Phone:662-299-5630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-22
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator