Provider Demographics
NPI:1417990391
Name:DUPREY, JAMES G (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:G
Last Name:DUPREY
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 1:29 EASTBROOK RD
Mailing Address - Street 2:
Mailing Address - City:RONKS
Mailing Address - State:PA
Mailing Address - Zip Code:17572-9769
Mailing Address - Country:US
Mailing Address - Phone:717-299-5711
Mailing Address - Fax:
Practice Address - Street 1:29 EASTBROOK RD
Practice Address - Street 2:
Practice Address - City:RONKS
Practice Address - State:PA
Practice Address - Zip Code:17572-9769
Practice Address - Country:US
Practice Address - Phone:717-299-5711
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD027869E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0879130Medicaid
PAC32526Medicare UPIN
PA0879130Medicaid