Provider Demographics
NPI:1538308150
Name:EWELL, JAMES ALFRED JR
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ALFRED
Last Name:EWELL
Suffix:JR
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 1:72B CENTENNIAL LOOP
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2446
Mailing Address - Country:US
Mailing Address - Phone:541-686-4310
Mailing Address - Fax:541-334-7645
Practice Address - Street 1:941 W 7TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-4611
Practice Address - Country:US
Practice Address - Phone:541-686-4310
Practice Address - Fax:541-334-7645
Is Sole Proprietor?:No
Enumeration Date:2009-02-05
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator