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NPI Code Detail

MEDICARE: JAMES C. ROCKWELL MD LLC

MEDICARE: JAMES C. ROCKWELL MD LLC
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
1207Y00000XOtolaryngology Physician2782AK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083848998
Entity Type Code : Organization
Provider Name (Legal Business Name) : JAMES C. ROCKWELL MD LLC
Provider Business Mailing Address
First Line : PO BOX 50150
Second Line :
City : BELLEVUE
State : WA
Zip : 98015-0150
Country : US
Telephone Number : 425-228-5228
Fax Number : 425-228-5733
Provider Business Practice Location Address
First Line : 130 CARLANNA LAKE RD
Second Line :
City : KETCHIKAN
State : AK
Zip : 99901-5611
Country : US
Telephone Number : 907-247-1515
Fax Number :
Authorized Official
Title or Position : OWNER
Name : JAMES C. ROCKWELL
Credential : MD
Telephone Number : 425-228-5228
Provider Enumeration Date : 05/06/2009
Last Update Date : 06/18/2009

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