Provider Demographics
NPI:1942772777
Name:FERCILIEN, JAMES BEAULIERE (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:BEAULIERE
Last Name:FERCILIEN
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:1357 OCONEE CONNECTOR BLDG300
Mailing Address - Street 2:
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-7314
Mailing Address - Country:US
Mailing Address - Phone:706-549-8306
Mailing Address - Fax:
Practice Address - Street 1:195 KING AVE
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-6736
Practice Address - Country:US
Practice Address - Phone:706-549-8306
Practice Address - Fax:706-549-8351
Is Sole Proprietor?:No
Enumeration Date:2018-12-18
Last Update Date:2019-03-19
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant