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Individual

DR. JAMES S FORAGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
861 CORONADO CENTER DR, SUITE 200, HENDERSON, NV 89052-3992
(702) 896-0940
(702) 896-6173
Mailing address
PO BOX 95306, LAS VEGAS, NV 89193-5306
(702) 948-8897
(702) 549-3178

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
10801
NV
207T00000X
Neurological Surgery Physician
29906
AZ
207T00000X
Neurological Surgery Physician
A65008
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1699732917
NV
05
635005
AZ
01
DL023Z
MEDICARE PTAN
NV
01
P00180750
RAILROAD MEDICARE
NV
Enumeration date
04/28/2006
Last updated
06/18/2021
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