Detrick, James

Detrick, James is an individual health care provider with primary practice located at 11020 Hull Street Rd , Midlothian VA 23112-3200. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Detrick, James can be contacted via phone (804) 744-6310.

Contact Information

Primary practice address
11020 Hull Street Rd Midlothian VA 23112-3200
Phone: (804) 744-6310
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PENDING North Carolina
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 0110002348 Virginia

Profile Details

NPI number 1346273869
LBN Legal business name Detrick, James
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 8th, 2006
Last updated Oct 18th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346273869 NPPES
North Carolina Other PENDING TRICARE PROVIDER NUMBER

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