Provider Demographics
NPI:1033421037
Name:FERRELL, JAMES BRUCE (PA-C)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:BRUCE
Last Name:FERRELL
Suffix:
Gender:M
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:353 FAIRMONT BLVD
Mailing Address - Street 2:ATTEN CHRISTIE MSS
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-7375
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2201 JACKSON BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702-4386
Practice Address - Country:US
Practice Address - Phone:605-755-2273
Practice Address - Fax:605-755-3902
Is Sole Proprietor?:No
Enumeration Date:2010-07-07
Last Update Date:2014-06-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SD0741363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant