Provider Demographics
NPI:1013993443
Name:CARR, JAMES BRUCE II (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:BRUCE
Last Name:CARR
Suffix:II
Gender:M
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:46041 W BELLE AVENUE
Mailing Address - Street 2:
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85239
Mailing Address - Country:US
Mailing Address - Phone:520-868-8443
Mailing Address - Fax:520-868-1547
Practice Address - Street 1:2300 E PARHAM RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23228-3118
Practice Address - Country:US
Practice Address - Phone:804-264-7808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-18
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110004183363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant