Provider Demographics
NPI:1962468165
Name:BEMBRY, JAMES S (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:S
Last Name:BEMBRY
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 1:835 SWEITZER ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45331
Mailing Address - Country:US
Mailing Address - Phone:937-548-1141
Mailing Address - Fax:
Practice Address - Street 1:820 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:OH
Practice Address - Zip Code:45331-1206
Practice Address - Country:US
Practice Address - Phone:937-548-5365
Practice Address - Fax:937-548-4456
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35075593207V00000X
IN01092081A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
INM12240430OtherMEDICARE PTAN
IN300035504Medicaid
OH2112181Medicaid
IN1962468165OtherANTHEM PTAN