Dernocoeur, James

Dernocoeur, James is an individual health care provider with primary practice located at 200 Jefferson Ave Se , Grand Rapids MI 49503-4502. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is his primary health care specialty. Dernocoeur, James can be contacted via phone (800) 968-6866.

Contact Information

Primary practice address
200 Jefferson Ave Se Grand Rapids MI 49503-4502
Phone: (800) 968-6866
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 5601002553 Michigan
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 5601002553 Michigan

Profile Details

NPI number 1083609374
LBN Legal business name Dernocoeur, James
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 13th, 2005
Last updated Aug 11th, 2011 - about 13 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 1083609374 NPPES
Michigan Other 970004371 RAILROAD MEDICARE

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