Provider Demographics
NPI:1467441907
Name:EWING, JAMES A (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:EWING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:105 GREENBRIAR DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:CAMPBELLSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42718-9615
Mailing Address - Country:US
Mailing Address - Phone:270-465-3595
Mailing Address - Fax:270-789-2044
Practice Address - Street 1:105 GREENBRIAR DR
Practice Address - Street 2:SUITE A
Practice Address - City:CAMPBELLSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42718-9615
Practice Address - Country:US
Practice Address - Phone:270-465-3595
Practice Address - Fax:270-789-2044
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2014-07-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY15114207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65931966Medicaid
KYCG2235OtherRAILROAD MEDICARE
KYP400039340Medicare PIN
KYCG2235OtherRAILROAD MEDICARE