# JAMES R ANGEL MD PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** James R Angel MD
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073686143
- **Authorized official:** MR. JAMES RAYMOND ANGEL MD (OWNER)
- **Authorized official phone:** (270) 789-2471

## Contact information

- **Practice address:** 1698 OLD LEBANON RD, SUITE 3B, CAMPBELLSVILLE, KY 42718-9662
- **Practice address phone:** (270) 789-2471
- **Practice address fax:** (270) 465-4669
- **Mailing address:** 1698 OLD LEBANON RD, SUITE 3B, CAMPBELLSVILLE, KY 42718-9662
- **Mailing address phone:** (270) 789-2471
- **Mailing address fax:** (270) 465-4669

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | 20672 | KY | Yes |

## Other

- **Enumeration date:** 11/16/2006
- **Last updated:** 04/21/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 00000062594 | BS | — |
| 01 | — | 1170188 | PASSPORT | — |
| 01 | — | 2440585000 | PASSPORT ADVANTAGE | — |
| 05 | — | 64206725 | — | KY |