Provider Demographics
NPI:1801866009
Name:CARGILL, JAMES DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DAVID
Last Name:CARGILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:750 W HIGH ST
Mailing Address - Street 2:SUITE 150
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45801-3959
Mailing Address - Country:US
Mailing Address - Phone:419-227-1359
Mailing Address - Fax:419-227-7586
Practice Address - Street 1:750 W HIGH ST
Practice Address - Street 2:SUITE 150
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801-3959
Practice Address - Country:US
Practice Address - Phone:419-227-1359
Practice Address - Fax:419-227-7586
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35071437207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2018891Medicaid
OHD17946Medicare UPIN
OH2018891Medicaid