Provider Demographics
NPI:1639451347
Name:MCVAY, JAMES AUSTIN JR (BS)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:AUSTIN
Last Name:MCVAY
Suffix:JR
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1016 CAPITOL DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73003-5073
Mailing Address - Country:US
Mailing Address - Phone:405-923-5347
Mailing Address - Fax:
Practice Address - Street 1:1016 CAPITOL DR
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73003-5073
Practice Address - Country:US
Practice Address - Phone:405-923-5347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation