Provider Demographics
NPI:1336119981
Name:COMERFORD, JAMES STUART (DPM)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:STUART
Last Name:COMERFORD
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 ALDERSGATE RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6611
Mailing Address - Country:US
Mailing Address - Phone:501-224-1501
Mailing Address - Fax:501-376-7065
Practice Address - Street 1:1501 ALDERSGATE RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6611
Practice Address - Country:US
Practice Address - Phone:501-224-1501
Practice Address - Fax:501-376-7065
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR101213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR56513OtherHEALTH ADVANTAGE
AR56513OtherFIRSTSOURCE PPO
AR111021717Medicaid
AR56513OtherBLUE ADVANTAGE
AR56513OtherBCBS FEP
480017295OtherRR MEDICARE
AR56513OtherBLUE CROSS SHIELD
AR56513Medicare PIN
T20375Medicare UPIN
AR565137258Medicare Oscar/Certification
AR0566240001Medicare NSC