Provider Demographics
NPI:1891789921
Name:TAFF, JAMES H JR (PAA AAC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:H
Last Name:TAFF
Suffix:JR
Gender:M
Credentials:PAA AAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8417
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31908
Mailing Address - Country:US
Mailing Address - Phone:706-324-5482
Mailing Address - Fax:706-596-4293
Practice Address - Street 1:2122 MANCHESTER EXPRESSWAY
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904
Practice Address - Country:US
Practice Address - Phone:800-232-5703
Practice Address - Fax:334-279-1660
Is Sole Proprietor?:No
Enumeration Date:2005-09-05
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002452363A00000X, 367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA97BBGWGMedicare ID - Type Unspecified
R11439Medicare UPIN