Provider Demographics
NPI:1124667332
Name:FENLEY, JAMES LEWIS III
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:LEWIS
Last Name:FENLEY
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1627 RIVER RO DR
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406-2396
Mailing Address - Country:US
Mailing Address - Phone:478-363-9399
Mailing Address - Fax:
Practice Address - Street 1:4960 RICE MINE RD NE STE 40
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406-3136
Practice Address - Country:US
Practice Address - Phone:205-759-1519
Practice Address - Fax:205-750-8612
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-06
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1167245363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner