Basic Information
| Provider Information | |||||||||
| NPI: | 1033271853 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CAGLE | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | W | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 80846 | ||||||||
| Address2: | |||||||||
| City: | FAIRBANKS | ||||||||
| State: | AK | ||||||||
| PostalCode: | 997080846 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9074585178 | ||||||||
| FaxNumber: | 9074585180 | ||||||||
| Practice Location | |||||||||
| Address1: | 1650 COWLES ST | ||||||||
| Address2: | SUITE 280 NT | ||||||||
| City: | FAIRBANKS | ||||||||
| State: | AK | ||||||||
| PostalCode: | 997015998 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9074585178 | ||||||||
| FaxNumber: | 9074585180 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/15/2006 | ||||||||
| LastUpdateDate: | 01/06/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0200X | 46060 | CO | N | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 207P00000X | 46060 | CO | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | AK 7044 | AK | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207RC0200X | AK 7044 | AK | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine |
ID Information
| ID | Type | State | Issuer | Description | 04594040 | 05 | CO | MEDICAID | K163347 | 05 | AK | MEDICAID | 91356504 | 05 | CO | MEDICAID |