Provider Demographics
NPI:1972130029
Name:JAMES, AMBER MECHELLE
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:MECHELLE
Last Name:JAMES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 ROSE ST # C-246
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0293
Mailing Address - Country:US
Mailing Address - Phone:859-323-6162
Mailing Address - Fax:859-257-8934
Practice Address - Street 1:363 SOUTHCREST CIR STE 202
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-4737
Practice Address - Country:US
Practice Address - Phone:662-349-0311
Practice Address - Fax:662-349-0121
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MS35180208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program