Healthcare Provider Details

I. General information

NPI: 1013094515
Provider Name (Legal Business Name): JAMES ANDREW DRISCOLL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 03/03/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 SPLIT RAIL CT
SANTA ROSA CA
95403-0178
US

IV. Provider business mailing address

4001 SPLIT RAIL CT
SANTA ROSA CA
95403-0178
US

V. Phone/Fax

Practice location:
  • Phone: 512-459-6599
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberA113201
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number4301516147
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number72779
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberMD61672497
License Number StateWA
# 5
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number84535-20
License Number StateWI
# 6
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberMD29635
License Number StateME
# 7
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number3038
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: