Provider Demographics
NPI:1750411922
Name:VOLKENANT, JAMES ALAN (LD OPTICIAN)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ALAN
Last Name:VOLKENANT
Suffix:
Gender:M
Credentials:LD OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6458 N ORACLE RD # NO.1
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-5609
Mailing Address - Country:US
Mailing Address - Phone:520-742-0393
Mailing Address - Fax:
Practice Address - Street 1:6458 N ORACLE RD STE 1
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-5609
Practice Address - Country:US
Practice Address - Phone:520-742-0393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ1114156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician