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Individual

MR. JAMES RUSSELL MACSWORDS III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
111 OSBOURNE WAY, STE 101, GEORGETOWN, KY 40324-8004
(859) 570-0007
(859) 570-0500
Mailing address
111 OSBOURNE WAY, STE 101, GEORGETOWN, KY 40324-8004
(859) 570-0007
(859) 570-0500

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA040
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
95000402
KY
Enumeration date
05/17/2006
Last updated
11/15/2010
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