Provider Demographics
NPI:1881701449
Name:PACE, JAMES GIROD (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:GIROD
Last Name:PACE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 797
Mailing Address - Street 2:
Mailing Address - City:LILLIAN
Mailing Address - State:AL
Mailing Address - Zip Code:36549-0797
Mailing Address - Country:US
Mailing Address - Phone:251-962-4111
Mailing Address - Fax:251-962-4112
Practice Address - Street 1:12839 6TH ST
Practice Address - Street 2:
Practice Address - City:LILLIAN
Practice Address - State:AL
Practice Address - Zip Code:36549-0797
Practice Address - Country:US
Practice Address - Phone:251-962-4111
Practice Address - Fax:251-962-4112
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00013078207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0619272OtherAETNA
KY0004359376OtherAETNA
WI581732073 36549 A001OtherTRICARE
581732073 0001OtherCIGNA
ALB95500Medicare UPIN