Provider Demographics
NPI:1467213447
Name:PACE, JAMES
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:PACE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4107 E 51ST ST APT 114
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-3620
Mailing Address - Country:US
Mailing Address - Phone:918-361-5005
Mailing Address - Fax:
Practice Address - Street 1:4107 E 51ST ST APT 114
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-3620
Practice Address - Country:US
Practice Address - Phone:918-361-5005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist