Provider Demographics
NPI:1801811120
Name:MARCUM, JAMES PATRICK (PA)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:PATRICK
Last Name:MARCUM
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:303 NORTH CLYDE MORRIS BL
Mailing Address - Street 2:HALIFAX HEALTH MEDICAL CENTER
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-2709
Mailing Address - Country:US
Mailing Address - Phone:386-254-2285
Mailing Address - Fax:386-425-1304
Practice Address - Street 1:303 NORTH CLYDE MORRIS BL
Practice Address - Street 2:HALIFAX HEALTH MEDICAL CENTER
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-2709
Practice Address - Country:US
Practice Address - Phone:386-254-2285
Practice Address - Fax:386-425-1304
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2010-04-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPA2622363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL292516800Medicaid
FLU8160XMedicare PIN
FLQ71830Medicare UPIN