Provider Demographics
NPI:1689921462
Name:JAMES MEDICAL, LLC
Entity Type:Organization
Organization Name:JAMES MEDICAL, LLC
Other - Org Name:JAMES MEDICAL, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:SOLE MEMBER, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:VETRANO
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:814-201-2232
Mailing Address - Street 1:801 HOWARD AVE
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-4727
Mailing Address - Country:US
Mailing Address - Phone:814-201-2232
Mailing Address - Fax:
Practice Address - Street 1:801 HOWARD AVE
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-4727
Practice Address - Country:US
Practice Address - Phone:814-201-2232
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-10
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD061001L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty