Provider Demographics
NPI:1346783271
Name:SOWASH, JAMES JAY (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:JAY
Last Name:SOWASH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 TORREY PINES DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-4825
Mailing Address - Country:US
Mailing Address - Phone:573-442-9084
Mailing Address - Fax:
Practice Address - Street 1:1211 TORREY PINES DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-4825
Practice Address - Country:US
Practice Address - Phone:573-442-9084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-26
Last Update Date:2016-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010003269207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine