MEDICARE: DR. JAMES CHARLES COMSTOCK M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	17798	IA

General Provider Information

NPI Number	:	1689665341
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES CHARLES COMSTOCK M.D.

Provider Business Mailing Address
First Line	:	3420 INWOOD AVE
Second Line	:
City	:	LAKE CITY
State	:	IA
Zip	:	51449-7577
Country	:	US
Telephone Number	:	712-464-7251
Fax Number	:

Provider Business Practice Location Address
First Line	:	3420 INWOOD AVE
Second Line	:
City	:	LAKE CITY
State	:	IA
Zip	:	51449-7577
Country	:	US
Telephone Number	:	712-464-7251
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	09/09/2008

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