Provider Demographics
NPI:1922018332
Name:FLAIG, JAMES J (DO)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:J
Last Name:FLAIG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1005 HEALTH CENTER DR STE 201
Mailing Address - Street 2:
Mailing Address - City:MATTOON
Mailing Address - State:IL
Mailing Address - Zip Code:61938-4693
Mailing Address - Country:US
Mailing Address - Phone:217-238-6055
Mailing Address - Fax:217-258-2216
Practice Address - Street 1:1104 W EVERGREEN AVE
Practice Address - Street 2:
Practice Address - City:EFFINGHAM
Practice Address - State:IL
Practice Address - Zip Code:62401-1710
Practice Address - Country:US
Practice Address - Phone:217-347-2500
Practice Address - Fax:217-342-9775
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036115742208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036115742Medicaid
ILK28795Medicare PIN