Provider Demographics
NPI:1891767968
Name:MCANALLY, JAMES L (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:L
Last Name:MCANALLY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:842 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-7134
Mailing Address - Country:US
Mailing Address - Phone:541-618-5800
Mailing Address - Fax:541-779-3027
Practice Address - Street 1:842 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-7134
Practice Address - Country:US
Practice Address - Phone:541-618-5800
Practice Address - Fax:541-779-3027
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2023-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD282602085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM201048650OtherPRESBYTERIAN HEALTH/SALUD
OR270494Medicaid
NM92080766Medicaid
NM10014949OtherLOVELACE HEALTH/SALUD
QMYPR0068511OtherMOLINA
AZ907785Medicaid
NM201048650OtherPRESBYTERIAN HEALTH/SALUD
QMYPR0068511OtherMOLINA
NM10014949OtherLOVELACE HEALTH/SALUD