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Individual

JAMES LYLE LATIMER

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
16 CHURCH ST, MADRID, NY 13660-0189
(315) 322-8947
(315) 327-4048
Mailing address
16 CHURCH ST, PO BOX 189, MADRID, NY 13660-0189
(315) 327-8947
(315) 322-4048

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
150723
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
002628
BCBS
05
00715086
NY
01
089001
MVP
Enumeration date
09/02/2005
Last updated
07/08/2007
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