Provider Demographics
NPI:1548608094
Name:STRONG, JAMES DOYCE JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DOYCE
Last Name:STRONG
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3675 S PIMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83706-6416
Mailing Address - Country:US
Mailing Address - Phone:208-433-7893
Mailing Address - Fax:298-344-7893
Practice Address - Street 1:3675 S PIMMIT AVE
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706-6416
Practice Address - Country:US
Practice Address - Phone:208-433-7893
Practice Address - Fax:298-344-7893
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-06
Last Update Date:2013-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM-7961174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist