Provider Demographics
NPI:1295239457
Name:BAUCUM, JAMES RHODES (DO)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:RHODES
Last Name:BAUCUM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1000 FM 300
Mailing Address - Street 2:
Mailing Address - City:LEVELLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79336-6235
Mailing Address - Country:US
Mailing Address - Phone:806-894-7842
Mailing Address - Fax:806-300-8650
Practice Address - Street 1:103 W 11TH ST
Practice Address - Street 2:
Practice Address - City:BIG SPRING
Practice Address - State:TX
Practice Address - Zip Code:79720-2913
Practice Address - Country:US
Practice Address - Phone:432-517-4557
Practice Address - Fax:432-400-1406
Is Sole Proprietor?:No
Enumeration Date:2018-03-22
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU7165208D00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice