Provider Demographics
NPI:1326209081
Name:RALSTIN, JAMES HENRY (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:HENRY
Last Name:RALSTIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14708 W 71ST TER
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66216-4005
Mailing Address - Country:US
Mailing Address - Phone:913-268-5970
Mailing Address - Fax:
Practice Address - Street 1:14708 W 71ST TER
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66216-4005
Practice Address - Country:US
Practice Address - Phone:913-268-5970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-24
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-17648207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease