Provider Demographics
NPI:1255317418
Name:JAMES, BRUCE RICHARD (MD)
Entity type:Individual
Prefix:
First Name:BRUCE
Middle Name:RICHARD
Last Name:JAMES
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 1:4201 WESTOWN PKWY STE 236
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-6720
Mailing Address - Country:US
Mailing Address - Phone:515-401-1950
Mailing Address - Fax:515-401-1955
Practice Address - Street 1:4201 WESTOWN PKWY STE 236
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-6720
Practice Address - Country:US
Practice Address - Phone:515-401-1950
Practice Address - Fax:515-401-1955
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA30516207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAIA0167OtherJOHN DEERE PROVIDER #
IA050038841OtherRAILROAD MEDICARE #
IA4290OtherMIDLANDS PROVIDER #
IA51102OtherBLUE SHIELD PROVIDER #
IA0121764Medicaid
IA30516OtherTRICARE PROVIDER #
IA4290OtherMIDLANDS PROVIDER #