Provider Demographics
NPI:1881689453
Name:CLASSEN, JAMES ANTHONY (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ANTHONY
Last Name:CLASSEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 64367
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28306-0367
Mailing Address - Country:US
Mailing Address - Phone:910-323-2626
Mailing Address - Fax:910-483-6376
Practice Address - Street 1:1841 QUIET CV
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3857
Practice Address - Country:US
Practice Address - Phone:910-323-2626
Practice Address - Fax:910-483-6376
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-20
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC33010208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC35690OtherMED COST
NC1738884OtherUNITED HEALTH CARE
NC22788OtherBLUE CROSS BLUE SHIELD
NC8922788Medicaid
NC213218FMedicare PIN
NCE12473Medicare UPIN