Provider Demographics
NPI:1710085725
Name:HAILE, JAMES B JR (MD)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:B
Last Name:HAILE
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:250 E LIBERTY ST
Mailing Address - Street 2:714
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1537
Mailing Address - Country:US
Mailing Address - Phone:502-582-2830
Mailing Address - Fax:502-582-2610
Practice Address - Street 1:250 E LIBERTY ST
Practice Address - Street 2:714 JB HAILE MD
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1537
Practice Address - Country:US
Practice Address - Phone:502-582-2830
Practice Address - Fax:502-582-2610
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
KY22346207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64223464Medicaid
KY000000039734OtherBCBS
C75207Medicare UPIN
KY64223464Medicaid