Provider Demographics
NPI:1679570642
Name:CAGLE, JAMES IRLEY JR (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:IRLEY
Last Name:CAGLE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:505 W PERSHING BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72114-2147
Mailing Address - Country:US
Mailing Address - Phone:501-758-7352
Mailing Address - Fax:501-771-5014
Practice Address - Street 1:505 W PERSHING BLVD
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72114-2147
Practice Address - Country:US
Practice Address - Phone:501-758-1002
Practice Address - Fax:501-771-5014
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARE0084207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR125187001Medicaid
ARF79630Medicare UPIN
AR5J386Medicare PIN