Provider Demographics
NPI:1336132265
Name:DALE, JAMES G (DO)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:G
Last Name:DALE
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:250 MEMORIAL DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:LURAY
Mailing Address - State:VA
Mailing Address - Zip Code:22835-1000
Mailing Address - Country:US
Mailing Address - Phone:540-743-6558
Mailing Address - Fax:540-743-3601
Practice Address - Street 1:250 MEMORIAL DR
Practice Address - Street 2:SUITE D
Practice Address - City:LURAY
Practice Address - State:VA
Practice Address - Zip Code:22835-1000
Practice Address - Country:US
Practice Address - Phone:540-743-6558
Practice Address - Fax:540-743-3601
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-25
Last Update Date:2021-02-28
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Provider Licenses
StateLicense IDTaxonomies
VA0102035799207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006046193Medicaid
VAB06629Medicare UPIN
VA006046193Medicaid