Provider Demographics
NPI:1780655704
Name:FOLLETTE, JAMES WARD (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:WARD
Last Name:FOLLETTE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13 SENECA AVE
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:NY
Mailing Address - Zip Code:13421-2555
Mailing Address - Country:US
Mailing Address - Phone:315-280-0363
Mailing Address - Fax:315-280-0579
Practice Address - Street 1:13 SENECA AVE
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:NY
Practice Address - Zip Code:13421-2555
Practice Address - Country:US
Practice Address - Phone:315-280-0363
Practice Address - Fax:315-280-0579
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-28
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY144544207LA0401X, 207LA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LA0401XAllopathic & Osteopathic PhysiciansAnesthesiologyAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00713882Medicaid