Provider Demographics
NPI:1609976125
Name:BIRD, JAMES DANIEL SR (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:DANIEL
Last Name:BIRD
Suffix:SR
Gender:M
Credentials:PA-C
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:DEPARTMENT OF STATE
Mailing Address - Street 2:AMERICAN EMBASSY-MEDICAL UNIT
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09316
Mailing Address - Country:IQ
Mailing Address - Phone:914-822-2649
Mailing Address - Fax:703-343-8684
Practice Address - Street 1:U S DEPARTMENT OF STATE
Practice Address - Street 2:M/MED/QI, SA-1
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20522-0001
Practice Address - Country:US
Practice Address - Phone:914-822-2649
Practice Address - Fax:703-343-8684
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ2714363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant