Individual
JAMES EDWARD PAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 LEE ST, WINSLOW, AZ 86047-2603
(928) 289-3396
(928) 289-2801
Mailing address
200 LEE ST, WINSLOW, AZ 86047-2603
(928) 289-3396
(928) 289-2801
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
25792
OK
207Q00000X
Family Medicine Physician
Primary
45775
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25792
STATE LICENSE #
OK
01
—
45775
MEDICAL LICENSE
AZ
05
—
683667
—
AZ
Enumeration date
07/30/2008
Last updated
07/20/2016
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