Provider Demographics
NPI:1336190685
Name:CREECH, JAMES C (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:C
Last Name:CREECH
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 1:926 N 8TH ST
Mailing Address - Street 2:
Mailing Address - City:ESTHERVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:51334-1300
Mailing Address - Country:US
Mailing Address - Phone:712-362-5650
Mailing Address - Fax:712-362-7190
Practice Address - Street 1:926 N 8TH ST
Practice Address - Street 2:
Practice Address - City:ESTHERVILLE
Practice Address - State:IA
Practice Address - Zip Code:51334-1300
Practice Address - Country:US
Practice Address - Phone:712-362-5650
Practice Address - Fax:712-362-7190
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA26635207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0042580Medicaid
IAE29310Medicare UPIN
IA0042580Medicaid