Individual
JAMES R POLIQUIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
911 BYPASS RD, PIKEVILLE, KY 41501-1689
(606) 218-4530
(606) 218-4540
Mailing address
PO BOX 2917, PIKEVILLE, KY 41502-2917
(606) 218-4530
(606) 218-4540
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
0101033088
VA
2086S0129X
Vascular Surgery Physician
0101033088
VA
2086S0129X
Vascular Surgery Physician
Primary
42475
KY
208C00000X
Colon & Rectal Surgery Physician
0101033088
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020044164
RAILROAD MEDICARE
—
01
—
0582455
AETNA HMO
—
01
—
071140
ANTHEM
—
01
—
1458520
CIGNA
—
01
—
15802
OPTIMA MEDICAID
VA
01
—
213383
OPTIMUM CHOICE
—
01
—
285008
SOUTHERN HEALTH
—
01
—
4357943
AETNA PPO/MC
—
05
—
7100175390
—
KY
Enumeration date
05/19/2006
Last updated
04/12/2012
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