Provider Demographics
NPI:1851463160
Name:DECOURCEY, JAMES P (DO)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:P
Last Name:DECOURCEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 MEDICAL CENTER PKWY
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-8160
Mailing Address - Country:US
Mailing Address - Phone:207-622-1959
Mailing Address - Fax:207-430-4007
Practice Address - Street 1:35 MEDICAL CENTER PKWY
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-8160
Practice Address - Country:US
Practice Address - Phone:207-622-1959
Practice Address - Fax:207-430-4007
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDO1908207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEG76152OtherHPHC
MEP00285922Medicare ID - Type UnspecifiedRAILROAD
ME3240685OtherAETNA
MEME1658Medicare ID - Type Unspecified
NH30224189Medicaid
ME3337001OtherCIGNA
ME432011799Medicaid
ME061538OtherANTHEM
MEME165801Medicare PIN
MEG76152Medicare UPIN