Provider Demographics
NPI:1760560619
Name:PAGE, JAMES E (PA)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:E
Last Name:PAGE
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:9601 LILE DR
Mailing Address - Street 2:SUITE 860
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6321
Mailing Address - Country:US
Mailing Address - Phone:501-975-7456
Mailing Address - Fax:501-978-1822
Practice Address - Street 1:9601 LILE DR
Practice Address - Street 2:SUITE 860
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6321
Practice Address - Country:US
Practice Address - Phone:901-975-7456
Practice Address - Fax:501-978-1822
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2008-06-12
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Provider Licenses
StateLicense IDTaxonomies
TN690363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3667785Medicare ID - Type Unspecified