Provider Demographics
NPI:1447316807
Name:MAGAURAN, JAMES JO (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:JO
Last Name:MAGAURAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 BEDFORD ST STE 34
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02420-4641
Mailing Address - Country:US
Mailing Address - Phone:617-548-8111
Mailing Address - Fax:781-861-8729
Practice Address - Street 1:76 BEDFORD ST STE 34
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02420-4641
Practice Address - Country:US
Practice Address - Phone:617-548-8111
Practice Address - Fax:781-861-8729
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2018-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2172272084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry