Individual
MR. JAMES CECIL LABRESH
Active
Individual
MR. JAMES CECIL LABRESH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA-79
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
515-39606
BCBS OF AL
AL
01
—
P00395581
RAILROAD MEDICARE PIN
—
Enumeration date
07/31/2006
Last updated
12/30/2007
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