Provider Demographics
NPI:1588669634
Name:BULL, JAMES A (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:BULL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:865 LINCOLN RD
Mailing Address - Street 2:STE L10
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-4159
Mailing Address - Country:US
Mailing Address - Phone:563-355-9191
Mailing Address - Fax:563-355-3419
Practice Address - Street 1:855 ILLINI DR
Practice Address - Street 2:STE 300
Practice Address - City:SILVIS
Practice Address - State:IL
Practice Address - Zip Code:61282-2904
Practice Address - Country:US
Practice Address - Phone:309-792-7060
Practice Address - Fax:309-792-4935
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2007-07-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA97833OtherWELLMARK BC/BS
020345OtherHEALTH ALLIANCE
20133OtherIOWA HEALTH SOLUTIONS
47968790024OtherDMERC
IA97785OtherWELLMARK BC/BS
4796890017OtherDMERC
IL0107OtherJOHN DEERE HEALTH PLAN
IA97833OtherWELLMARK BC/BS
ILL86101Medicare PIN