Provider Demographics
NPI:1588602379
Name:PERSING, JAMES SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:SCOTT
Last Name:PERSING
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 1:1501 ELDERBERRY LN
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-9454
Mailing Address - Country:US
Mailing Address - Phone:715-839-8151
Mailing Address - Fax:
Practice Address - Street 1:808 MAIN ST E
Practice Address - Street 2:
Practice Address - City:MENOMONIE
Practice Address - State:WI
Practice Address - Zip Code:54751-2735
Practice Address - Country:US
Practice Address - Phone:715-232-1116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI41015-0202084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1021355OtherPREFERREDONE PIN
WI62543OtherSECURITY HEALTH PLAN ID
MN6966OtherMMSI PROVIDER NUMBER
WI32556900Medicaid
MN438962000OtherMN STATE HUMAN SERVICE ID
MN438962000OtherMN STATE HUMAN SERVICE ID
WIG90901Medicare UPIN
WI000184475Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID