Provider Demographics
NPI:1144317801
Name:VANCE, JAMES M (PA)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:VANCE
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:350 SOUTH LOWE AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501
Mailing Address - Country:US
Mailing Address - Phone:931-526-1050
Mailing Address - Fax:931-526-8163
Practice Address - Street 1:350 S LOWE AVE
Practice Address - Street 2:SUITE A
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501
Practice Address - Country:US
Practice Address - Phone:931-526-1050
Practice Address - Fax:931-526-8163
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
TNPA207363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical