Provider Demographics
NPI:1730249582
Name:PINGREE, JAMES C (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:C
Last Name:PINGREE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1220 E 3900 S STE 4E
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84124-1343
Mailing Address - Country:US
Mailing Address - Phone:801-261-8507
Mailing Address - Fax:801-261-8511
Practice Address - Street 1:1220 E 3900 S STE 4E
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84124-1343
Practice Address - Country:US
Practice Address - Phone:801-261-8507
Practice Address - Fax:801-261-8511
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT344599-1205207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTH63060Medicare UPIN