Basic Information
Provider Information
NPI: 1710098058
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROWLEY
FirstName: JAMES
MiddleName: G
NamePrefix:  
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5848 FASHION BLVD
Address2:  
City: MURRAY
State: UT
PostalCode: 841076121
CountryCode: US
TelephoneNumber: 8013144130
FaxNumber: 8013144015
Practice Location
Address1: 5848 FASHION BLVD
Address2:  
City: MURRAY
State: UT
PostalCode: 841076121
CountryCode: US
TelephoneNumber: 8013144130
FaxNumber: 8013144015
Other Information
ProviderEnumerationDate: 08/31/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363AS0400X341788-1206UTY Physician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical

No ID Information.


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