Provider Demographics
NPI:1457322927
Name:JAMES, JOHN M (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:M
Last Name:JAMES
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 1:1136 E STUART ST
Mailing Address - Street 2:BUILDING 3, SUITE 3200
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-1195
Mailing Address - Country:US
Mailing Address - Phone:970-221-1681
Mailing Address - Fax:970-221-0948
Practice Address - Street 1:125 RAMPART WAY
Practice Address - Street 2:SUITE 200
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-6406
Practice Address - Country:US
Practice Address - Phone:720-858-7600
Practice Address - Fax:720-858-7605
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO36090174400000X
WY6005A174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO94233365Medicaid
COE42223Medicare UPIN
COC19534Medicare PIN
CO030004155Medicare PIN