Provider Demographics
NPI:1912909227
Name:JAMES, MILTON (MD)
Entity Type:Individual
Prefix:DR
First Name:MILTON
Middle Name:
Last Name:JAMES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4102 N ROXBORO ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-2122
Mailing Address - Country:US
Mailing Address - Phone:919-595-2000
Mailing Address - Fax:919-595-2182
Practice Address - Street 1:4102 N ROXBORO ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-2122
Practice Address - Country:US
Practice Address - Phone:919-595-2000
Practice Address - Fax:919-595-2182
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35077543207W00000X
PAMD069803L207W00000X
WV20115207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0895377OtherMCR #OTHER TAX ID
WV6300115000Medicaid
OH2150630Medicaid
PA0017726390004Medicaid
OHP00336309OtherRRMCR # OTHER TAX ID
OH0895371Medicare PIN
OHP00336309OtherRRMCR # OTHER TAX ID
OHG54503Medicare UPIN
OH0895374Medicare PIN
OH0895373Medicare PIN
OH180038217Medicare PIN
OH180038216Medicare PIN
PA180038219Medicare PIN
OH180038218Medicare PIN
OH2150630Medicaid