Provider Demographics
NPI:1831230150
Name:NESS, JAMES A (OD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:A
Last Name:NESS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:100 ROLLINGBROOK NE
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:MI
Mailing Address - Zip Code:49301-9015
Mailing Address - Country:US
Mailing Address - Phone:616-540-3159
Mailing Address - Fax:
Practice Address - Street 1:2860 E BELTLINE AVE NE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-9704
Practice Address - Country:US
Practice Address - Phone:616-364-8484
Practice Address - Fax:616-364-9686
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901003642152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIU37639Medicare UPIN