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NPI Code Detail

MEDICARE: JAMES ALAN BRUCE M.D.

MEDICARE: JAMES ALAN BRUCE 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
1207L00000XAnesthesiology Physician35041548OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2UNITED HEALTHCAREOTHEROH2000594
3000000005969OTHEROHANTHEM

General Provider Information

NPI Number : 1720089352
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES ALAN BRUCE M.D.
Provider Business Mailing Address
First Line : 3533 SOUTHERN BLVD
Second Line : SUITE 3100
City : KETTERING
State : OH
Zip : 45429-1264
Country : US
Telephone Number : 937-293-8228
Fax Number : 937-293-8229
Provider Business Practice Location Address
First Line : 3535 SOUTHERN BLVD
Second Line :
City : KETTERING
State : OH
Zip : 45429-1221
Country : US
Telephone Number : 937-435-6136
Fax Number : 937-435-6135
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2005
Last Update Date : 07/08/2007

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Directions to “ JAMES ALAN BRUCE M.D.” Practice Location

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