Provider Demographics
NPI:1851691323
Name:ANNIS, JAMES WILLIAM JR (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:WILLIAM
Last Name:ANNIS
Suffix:JR
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:PO BOX 8500 LOCKBOX 7642
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-7642
Mailing Address - Country:US
Mailing Address - Phone:813-281-8115
Mailing Address - Fax:813-281-8656
Practice Address - Street 1:911 W 5TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2901
Practice Address - Country:US
Practice Address - Phone:509-455-7844
Practice Address - Fax:509-623-0415
Is Sole Proprietor?:No
Enumeration Date:2010-10-29
Last Update Date:2017-10-23
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Provider Licenses
StateLicense IDTaxonomies
WAPA60191284363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical