Provider Demographics
NPI:1467531756
Name:TOOLEY, JAMES E JR (DO, PC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:E
Last Name:TOOLEY
Suffix:JR
Gender:M
Credentials:DO, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 35380
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89133-5380
Mailing Address - Country:US
Mailing Address - Phone:702-954-7500
Mailing Address - Fax:702-266-8749
Practice Address - Street 1:4730 E GRANT RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2703
Practice Address - Country:US
Practice Address - Phone:520-290-0300
Practice Address - Fax:520-298-9230
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2341207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1Z7614OtherHEALTHNET
AZ1780929380Other(NPI#2) GROUP NPI
AZAZ0220420OtherBCBS
AZ271388Medicaid
AZAZ0220420OtherBCBS
AZBCNVXMedicare ID - Type Unspecified