Provider Demographics
NPI:1578767174
Name:BYNUM, JAMES ALTON (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ALTON
Last Name:BYNUM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7331 COLLEGE PKWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-5524
Mailing Address - Country:US
Mailing Address - Phone:239-337-2003
Mailing Address - Fax:239-337-1483
Practice Address - Street 1:7331 COLLEGE PKWY
Practice Address - Street 2:SUITE 300
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-5524
Practice Address - Country:US
Practice Address - Phone:239-337-2003
Practice Address - Fax:239-337-3168
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME104582207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
685204150OtherMYUTMB 685204150-COMMERCIAL NUMBER