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Individual

JAMES A AVERY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
210 WISCONSIN AMERICAN DR, SUITE #265, FOND DU LAC, WI 54935-2999
(920) 907-7400
(920) 907-7401
Mailing address
210 WISCONSIN AMERICAN DR, SUITE #265, FOND DU LAC, WI 54935-2999
(920) 907-7400
(920) 907-7401

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
24651-020
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30463800
WI
Enumeration date
08/23/2005
Last updated
06/13/2014
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