Provider Demographics
NPI:1285211714
Name:BOBCO, JAMES ROBERT JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ROBERT
Last Name:BOBCO
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:3 SAINT ELIZABETH BLVD STE 4000
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:IL
Mailing Address - Zip Code:62269-1284
Mailing Address - Country:US
Mailing Address - Phone:618-256-9355
Mailing Address - Fax:618-206-2332
Practice Address - Street 1:3 SAINT ELIZABETH BLVD STE 4000
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:IL
Practice Address - Zip Code:62269-1284
Practice Address - Country:US
Practice Address - Phone:618-256-9355
Practice Address - Fax:618-206-2332
Is Sole Proprietor?:No
Enumeration Date:2021-03-29
Last Update Date:2023-08-21
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE35475208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice