James Larry Boss, M.D.
Individual provider Active NPI Family Medicine Physician · Villa Rica, GA
NPI 1043432164 · NPPES record last updated Dec 14, 2007
Key facts
- NPI
- 1043432164
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 009437 (GA)
- Practice address
- 517 Leslie Dr
Villa Rica, GA 30180-2406 - Phone
- (770) 459-5179
- NPI assigned
- May 2, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 009437 | GA | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 009437 | GA | Yes |
Addresses
Primary practice location
517 Leslie Dr
Villa Rica, GA 30180-2406
Mailing address
517 Leslie Dr
Villa Rica, GA 30180-2406
Phone (770) 459-5179
Other providers in Villa Rica, GA
- Shandon Boddy
- Chelsea Grant Bode
- William Todd Boleman
- Bonnie Kristine Boles
- Yolanda Therese Booker
- Johanna Linnea Bozeman
- Carter Dale Brannon
- Brian a Bain DDS III PC
- Ann Hamilton Brown
- Benita N Brown
All providers in Villa Rica, GA · Family Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 14, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.