Provider Demographics
NPI:1750497400
Name:HANDLEY, JOHN A III (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:A
Last Name:HANDLEY
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:168 NORTH BRENT STREET
Mailing Address - Street 2:SUITE 406
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-2824
Mailing Address - Country:US
Mailing Address - Phone:805-653-6371
Mailing Address - Fax:805-653-7242
Practice Address - Street 1:168 NORTH BRENT STREET
Practice Address - Street 2:SUITE 406
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-2824
Practice Address - Country:US
Practice Address - Phone:805-653-6371
Practice Address - Fax:805-653-7242
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG46618207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Not Answered207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD44014Medicare UPIN