Provider Demographics
NPI:1679681183
Name:CATO, JAMES ALVIN III (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ALVIN
Last Name:CATO
Suffix:III
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 1:2123 WRIGHTSBORO RD
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30904-4777
Mailing Address - Country:US
Mailing Address - Phone:706-736-5244
Mailing Address - Fax:706-736-5246
Practice Address - Street 1:2123 WRIGHTSBORO RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30904-4777
Practice Address - Country:US
Practice Address - Phone:706-736-5244
Practice Address - Fax:706-736-5246
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC19809207R00000X
GA034520207R00000X
193400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes193400000XGroupSingle Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000506294BMedicaid
SCG34520Medicaid
SCG34520Medicaid
GA11BDMQQMedicare ID - Type Unspecified