Provider Demographics
NPI:1932209665
Name:MACON, JAMES B III (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:B
Last Name:MACON
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:332 WASHINGTON ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481-6219
Mailing Address - Country:US
Mailing Address - Phone:866-774-6337
Mailing Address - Fax:781-235-3212
Practice Address - Street 1:332 WASHINGTON ST
Practice Address - Street 2:SUITE 205
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-6219
Practice Address - Country:US
Practice Address - Phone:866-774-6337
Practice Address - Fax:781-235-3212
Is Sole Proprietor?:No
Enumeration Date:2006-09-23
Last Update Date:2021-01-07
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Provider Licenses
StateLicense IDTaxonomies
MA40944207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAC07109OtherBCBS
B97254Medicare UPIN
MAC07109Medicare ID - Type Unspecified