Provider Demographics
NPI:1538101340
Name:OLES, JAMES RICHARD (PA-C)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:RICHARD
Last Name:OLES
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:WHITEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28472-3416
Mailing Address - Country:US
Mailing Address - Phone:910-642-3214
Mailing Address - Fax:910-642-2085
Practice Address - Street 1:220 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:WHITEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28472-3416
Practice Address - Country:US
Practice Address - Phone:910-642-3214
Practice Address - Fax:910-642-2085
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC102944363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2752693AMedicare PIN
NCS96116Medicare UPIN