Provider Demographics
NPI:1316015274
Name:BOTTS, JAMES SHORTLE (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:SHORTLE
Last Name:BOTTS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:407 E ZIA DR
Mailing Address - Street 2:
Mailing Address - City:HOBBS
Mailing Address - State:NM
Mailing Address - Zip Code:88240-3428
Mailing Address - Country:US
Mailing Address - Phone:505-397-1835
Mailing Address - Fax:505-393-5326
Practice Address - Street 1:VISTACARE HOSPICE
Practice Address - Street 2:1515 W. CALLE SUR
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240
Practice Address - Country:US
Practice Address - Phone:505-392-2060
Practice Address - Fax:505-392-2060
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NM70-107207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine