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General NPI Number Information
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NPI Number | 1891714713
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Entity Type | Individual
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Provider Name | JAMES E ROUKEMA D.O.
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Gender | Male
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 10/27/2021
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Provider Practice Location Address
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Address Line | 1311A N MILDRED RD
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City | CORTEZ
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State | CO
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Zip | 81321-2231
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Country | US
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Telephone | 970-565-8556
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 560825
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City | DENVER
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State | CO
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Zip | 80256-0825
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Country | US
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Telephone | 719-595-7580
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Fax | 719-545-0176
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 28101
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License Number State | CO
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