Provider Demographics
NPI:1871587063
Name:LAPOLLA, JAMES J JR (DPM)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:J
Last Name:LAPOLLA
Suffix:JR
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8588 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-2339
Mailing Address - Country:US
Mailing Address - Phone:330-856-4444
Mailing Address - Fax:330-856-9033
Practice Address - Street 1:8588 E MARKET ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-2339
Practice Address - Country:US
Practice Address - Phone:330-856-4444
Practice Address - Fax:330-856-9033
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-02
Last Update Date:2024-04-29
Deactivation Date:2006-03-24
Deactivation Code:
Reactivation Date:2006-04-04
Provider Licenses
StateLicense IDTaxonomies
332B00000X
OH36002617213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0787733Medicaid
OHU12891Medicare UPIN