Provider Demographics
NPI:1023076213
Name:RISING, JAMES LLOYD (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:LLOYD
Last Name:RISING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:HC 78 BOX 111D
Mailing Address - Street 2:
Mailing Address - City:DELRAY
Mailing Address - State:WV
Mailing Address - Zip Code:26714-9701
Mailing Address - Country:US
Mailing Address - Phone:304-496-8880
Mailing Address - Fax:304-496-8217
Practice Address - Street 1:17978 SR 55
Practice Address - Street 2:
Practice Address - City:BAKER
Practice Address - State:WV
Practice Address - Zip Code:26801
Practice Address - Country:US
Practice Address - Phone:304-897-5915
Practice Address - Fax:304-897-6216
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV20663208D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1023076213OtherNPI
WV1840098000Medicaid
WVG21710Medicare UPIN
WV9189782Medicare PIN