Provider Demographics
NPI:1477522373
Name:DENNEMEYER, JAMES ERIC (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:ERIC
Last Name:DENNEMEYER
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:844 N THORNTON AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-4003
Mailing Address - Country:US
Mailing Address - Phone:407-398-6470
Mailing Address - Fax:407-894-6872
Practice Address - Street 1:8573 E SAN ALBERTO STE E100
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4612
Practice Address - Country:US
Practice Address - Phone:480-778-1732
Practice Address - Fax:480-778-1709
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD 034462E208000000X
AZ29525208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001665399Medicaid
FL010450600Medicaid
AZ620428Medicaid