Individual
DR. JAMES W MCILWAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
901 PATIENTS FIRST DR, WASHINGTON, MO 63090-4700
(636) 390-1570
(636) 390-1571
Mailing address
901 PATIENTS FIRST DR, WASHINGTON, MO 63090-4700
(636) 390-1570
(636) 390-1571
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
2002002082
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204576300
—
MO
01
—
P00445875
RAILROOAD MEDICARE
—
Enumeration date
10/31/2005
Last updated
01/23/2012
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