Provider Demographics
NPI:1760425169
Name:COOMBS, JAMES MORGAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MORGAN
Last Name:COOMBS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JAMES
Other - Middle Name:MORGAN
Other - Last Name:COOMBS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1415 PARKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-3250
Mailing Address - Country:US
Mailing Address - Phone:208-734-8934
Mailing Address - Fax:208-734-8974
Practice Address - Street 1:1415 PARKVIEW DR
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-3250
Practice Address - Country:US
Practice Address - Phone:208-734-8934
Practice Address - Fax:208-734-8974
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM9542207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID807467700Medicaid
IDI58379Medicare UPIN
ID1133495Medicare ID - Type UnspecifiedMEDICARE