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Individual

JAMES L DELINE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
307 MCKAY ST, MACON, MO 63552-2029
(660) 385-3141
(660) 385-5866
Mailing address
307 MCKAY ST, MACON, MO 63552-2029
(660) 385-3141
(660) 385-5866

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
36425
MO
207Q00000X
Family Medicine Physician
Primary
MD 36425
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
010012805
RAILROAD MEDICARE
01
11794
BLUE CROSS
MO
05
1930156
IA
01
193025
THE FUNDS
05
202144804
MO
01
252291
HEALTHLINK HMO AND PPO
01
431671124DEL
MERCY HEALTH PLANS
MO
01
54535
UNITED HEALTHCARE
01
930078535
RAILROAD MEDICARE
Enumeration date
05/24/2005
Last updated
11/13/2015
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