Provider Demographics
NPI:1013913870
Name:VEST, JAMES V (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:V
Last Name:VEST
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:PO BOX 1500
Mailing Address - Street 2:
Mailing Address - City:OSAGE BEACH
Mailing Address - State:MO
Mailing Address - Zip Code:65065-1500
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:54 HOSPITAL DR
Practice Address - Street 2:SUITE 205
Practice Address - City:OSAGE BEACH
Practice Address - State:MO
Practice Address - Zip Code:65065-3050
Practice Address - Country:US
Practice Address - Phone:573-302-3199
Practice Address - Fax:573-302-3198
Is Sole Proprietor?:No
Enumeration Date:2005-06-24
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036053136207RP1001X
MO2004018055207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOP01103084OtherRAILROAD MEDICARE
IL036053136Medicaid
MO1013913870Medicaid
MOP01103084OtherRAILROAD MEDICARE
ILC41639Medicare UPIN
MO1013913870Medicaid