Provider Demographics
NPI:1942274956
Name:JAMES, CHARLES W (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:W
Last Name:JAMES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1900 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:COOS BAY
Mailing Address - State:OR
Mailing Address - Zip Code:97420-2045
Mailing Address - Country:US
Mailing Address - Phone:541-267-5151
Mailing Address - Fax:541-266-4501
Practice Address - Street 1:1900 WOODLAND DR
Practice Address - Street 2:
Practice Address - City:COOS BAY
Practice Address - State:OR
Practice Address - Zip Code:97420-2045
Practice Address - Country:US
Practice Address - Phone:541-267-5151
Practice Address - Fax:541-266-4501
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00037184208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR0000WFBTVOtherGROUP MEDICARE NORTH BEND MEDICAL CENTER
WA1413301Medicaid
WA20042093OtherRAIL ROAD MEDICARE
ORP01250297OtherRAILROAD MEDICARE-OREGON
WA127294OtherL&I
OR136211Medicaid
OR1407812365OtherGROUP NPI NORTH BEND MEDICAL CENTER
OR161133OtherGROUP MEDICAID NORTH BEND MEDICAL CENTER
OR93-0635514OtherGROUP TAX FOR BILLING NORTH BEND MEDICAL CENTER
WA20042093OtherRAIL ROAD MEDICARE
ORP01250297OtherRAILROAD MEDICARE-OREGON
WAG88938Medicare UPIN