Provider Demographics
NPI:1417497793
Name:FURRY, JAMES ROBERT IV (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ROBERT
Last Name:FURRY
Suffix:IV
Gender:M
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:6403 S AVALON AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-3103
Mailing Address - Country:US
Mailing Address - Phone:605-670-3423
Mailing Address - Fax:
Practice Address - Street 1:1315 S CLIFF AVE
Practice Address - Street 2:AVERA DOCTORS PLAZA 3
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-1058
Practice Address - Country:US
Practice Address - Phone:605-322-7350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-06
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SD363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant