Provider Demographics
NPI:1336103407
Name:MOLES, JAMES KELLY JR (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:KELLY
Last Name:MOLES
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1970 ROANOKE BLVD
Mailing Address - Street 2:BOX 116A7
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-6404
Mailing Address - Country:US
Mailing Address - Phone:540-982-2463
Mailing Address - Fax:540-983-1086
Practice Address - Street 1:1970 ROANOKE BLVD
Practice Address - Street 2:BOX 116A7
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-6404
Practice Address - Country:US
Practice Address - Phone:540-982-2463
Practice Address - Fax:540-983-1086
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2022-02-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101042255207R00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine