Provider Demographics
NPI:1689849341
Name:JAMES D. KINDL, MD PA
Entity type:Organization
Organization Name:JAMES D. KINDL, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:KINDL
Authorized Official - Suffix:
Authorized Official - Credentials:MD PA
Authorized Official - Phone:336-272-3292
Mailing Address - Street 1:719 GREEN VALLEY RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-7014
Mailing Address - Country:US
Mailing Address - Phone:336-272-3292
Mailing Address - Fax:336-272-4318
Practice Address - Street 1:719 GREEN VALLEY RD
Practice Address - Street 2:SUITE 301
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-7014
Practice Address - Country:US
Practice Address - Phone:336-272-3292
Practice Address - Fax:336-272-4318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8948988Medicaid
NCC84927Medicare UPIN
NC8948988Medicaid