Healthcare Provider Details

I. General information

NPI: 1326985367
Provider Name (Legal Business Name): RED ROCK SPECIALISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1136 BRITISH COLUMBIA AVE
AMES IA
50014-3730
US

IV. Provider business mailing address

1136 BRITISH COLUMBIA AVE
AMES IA
50014-3730
US

V. Phone/Fax

Practice location:
  • Phone: 616-482-7168
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: AUSTIN BANCROFT
Title or Position: OWNER
Credential: DO
Phone: 616-482-7168