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JAMES D. MICKLE JR. MD NPI 1477855104


NPI Information

NPI: 1477855104
Provider Name: JAMES D. MICKLE, JR. MD

Doing Business As: CHOLESTEROL STUDIES AND TREATMENT

Classification: Clinic/Center - 261QM2500X
Entity Type: Organization

Specialization: Medical Specialty

Address:
4 CALLE MEDICO
C
SANTA FE, NM
ZIP 87505
Phone: (610) 952-4418
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JAMES D. MICKLE, JR. MD is a medical specialty clinic center in Santa Fe, NM. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). JAMES D. MICKLE, JR. MD NPI is 1477855104. The provider is registered as an organization entity type.
The provider Is Doing Business As Cholesterol Studies And Treatment.

The provider's business location address is:

4 CALLE MEDICO
C
SANTA FE, NM
ZIP 87505-791
Phone: (610) 952-4418
Fax: (610) 369-2710

The provider's authorized official is James D. Mickle .
The authorized official title is Sole Proprietor and has the following contact phone number (610) 952-4418.

The enumeration date for this NPI number is 12/1/2010 and was last updated on 12/1/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM2500XClinic/CenterMedical SpecialtyMD2008-0397NEW MEXICOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1B38961MEDICARE UPINPENNSYLVANIA
2502171OTHERPENNSYLVANIAMEDICARE ID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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