Provider Demographics
NPI:1750375135
Name:EGEL, JAMES W (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:W
Last Name:EGEL
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:PO BOX 2379
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-2379
Mailing Address - Country:US
Mailing Address - Phone:606-408-6200
Mailing Address - Fax:606-408-5338
Practice Address - Street 1:613 23RD ST STE 130
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-2876
Practice Address - Country:US
Practice Address - Phone:606-329-9335
Practice Address - Fax:606-324-6383
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY23583207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0560727Medicaid
WV0087997000Medicaid
KY390001591OtherRAILROAD MEDICARE
KY64235831Medicaid
OHEG0811551Medicare ID - Type Unspecified
WV0087997000Medicaid
C69080Medicare UPIN