Individual
JAMES RUSSELL DEVILLIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
296 DENADA PATH, ROXBORO, NC 27574-6306
(336) 659-9440
(336) 659-9845
Mailing address
296 DENADA PATH, ROXBORO, NC 27574-6306
(336) 659-9440
(336) 659-9845
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
9500554
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
140WF
BCBS
NC
05
—
5900890
—
NC
Enumeration date
01/18/2007
Last updated
06/12/2013
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