Individual
JAMES R OUELLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2300 MIAMI VALLEY DR, SUITE 350, CENTERVILLE, OH 45459
(937) 424-2469
(937) 424-2479
Mailing address
3170 KETTERING BLVD BLDG B3, MORAINE, OH 45439-1924
(937) 991-3191
(937) 223-9811
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
34007386
OH
2086X0206X
Surgical Oncology Physician
Primary
340073869
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2192550
—
OH
Enumeration date
05/04/2006
Last updated
08/01/2018
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