Provider Demographics
NPI:1912112806
Name:FENTON, JAMES R (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:R
Last Name:FENTON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4000 WELLNESS DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48670-2000
Mailing Address - Country:US
Mailing Address - Phone:844-832-1956
Mailing Address - Fax:989-633-5241
Practice Address - Street 1:4100 CAMPUS RIDGE DR
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48670-1038
Practice Address - Country:US
Practice Address - Phone:989-794-2969
Practice Address - Fax:989-488-5455
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2023-03-24
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Provider Licenses
StateLicense IDTaxonomies
UT8228397-1205208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)