Individual
JAMES R NORTHERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
620 E MONROE ST, MEXICO, MO 65265-2919
(573) 581-5850
(573) 581-8185
Mailing address
201 E MONROE ST, SUITE 202, MEXICO, MO 65265-2852
(573) 581-5850
(573) 581-8185
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
R8A00
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
243605805
—
MO
01
—
300044909
MEDICARE RAILROAD
MO
Enumeration date
10/14/2005
Last updated
07/22/2010
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