Provider Demographics
NPI:1558369371
Name:FERLMANN, JAMES C (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:C
Last Name:FERLMANN
Suffix:
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:PO BOX 29650
Mailing Address - Street 2:DEPT 880392
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85038
Mailing Address - Country:US
Mailing Address - Phone:480-626-1746
Mailing Address - Fax:480-626-2690
Practice Address - Street 1:4915 E BASELINE RD STE 104
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-2966
Practice Address - Country:US
Practice Address - Phone:480-616-0676
Practice Address - Fax:480-546-5369
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-0797302086S0122X
AZ563962086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL363235315OtherTIN
ILF400183163Medicare PIN
ILF79094Medicare UPIN
ILF79094Medicare UPIN
IL036079730Medicaid