Provider Demographics
NPI:1346355716
Name:BANKSTON, JAMES H (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:H
Last Name:BANKSTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:125 ALISON DR STE 3
Mailing Address - Street 2:
Mailing Address - City:ALEXANDER CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35010-4410
Mailing Address - Country:US
Mailing Address - Phone:256-329-8459
Mailing Address - Fax:256-329-3337
Practice Address - Street 1:125 ALISON DR STE 3
Practice Address - Street 2:
Practice Address - City:ALEXANDER CITY
Practice Address - State:AL
Practice Address - Zip Code:35010-4410
Practice Address - Country:US
Practice Address - Phone:256-329-8459
Practice Address - Fax:256-329-3337
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA081717208800000X
AL6380208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL510-00262OtherBCBS
AL000000262Medicaid