Provider Demographics
NPI:1134955040
Name:HARRIS, JAMES W (CSFA)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:W
Last Name:HARRIS
Suffix:
Gender:M
Credentials:CSFA
Other - Prefix:
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Mailing Address - Street 1:7048 MIDDLEVALLEY WALK
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63123-2417
Mailing Address - Country:US
Mailing Address - Phone:314-775-1224
Mailing Address - Fax:
Practice Address - Street 1:7827 TOWN SQUARE AVE STE 104
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368-7199
Practice Address - Country:US
Practice Address - Phone:636-734-0386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical