Provider Demographics
NPI:1255447728
Name:GRAYBILL, JAMES WILLIAM III (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:WILLIAM
Last Name:GRAYBILL
Suffix:III
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 1123
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:34681-1123
Mailing Address - Country:US
Mailing Address - Phone:727-415-9535
Mailing Address - Fax:
Practice Address - Street 1:3202 ALTERNATE 19
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34683
Practice Address - Country:US
Practice Address - Phone:727-785-0375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01079292A207P00000X
WV21971146D00000X
FLFLME 977472083P0901X
FLME97747207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000383743OtherANTHEM
FL94357OtherBCBS OF FLORIDA
10196OtherPARAMOUNT
FL277986200Medicaid
FLP00477050Medicare PIN
000000383743OtherANTHEM
10196OtherPARAMOUNT
I44774Medicare UPIN