Provider Demographics
NPI:1255396636
Name:FORSEN, JAMES W (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:W
Last Name:FORSEN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:621 S NEW BALLAS RD
Mailing Address - Street 2:STE 622A
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8232
Mailing Address - Country:US
Mailing Address - Phone:314-872-8340
Mailing Address - Fax:314-872-8399
Practice Address - Street 1:621 S NEW BALLAS RD
Practice Address - Street 2:STE 622A
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8232
Practice Address - Country:US
Practice Address - Phone:314-872-8340
Practice Address - Fax:314-872-8399
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2011-05-03
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Provider Licenses
StateLicense IDTaxonomies
MOR9J63207YP0228X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric Otolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOE56454Medicare UPIN