Provider Demographics
NPI:1669475380
Name:JAMISON, JAMES P (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:P
Last Name:JAMISON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8591CROSSROADS DRIVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44514
Mailing Address - Country:US
Mailing Address - Phone:330-758-0577
Mailing Address - Fax:330-758-0466
Practice Address - Street 1:8591CROSSROADS DRIVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44514
Practice Address - Country:US
Practice Address - Phone:330-758-0577
Practice Address - Fax:330-758-0466
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.072635207X00000X
OH72635207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH341972661OtherTAX ID
OH0144169Medicaid
OH0144169Medicaid
OHG09350Medicare UPIN
OH0144169Medicaid