Provider Demographics
NPI:1649426503
Name:BLESSMAN, JAMES LEROY (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:LEROY
Last Name:BLESSMAN
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 1:4200 NW 98TH AVE
Mailing Address - Street 2:
Mailing Address - City:POLK CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50226-2089
Mailing Address - Country:US
Mailing Address - Phone:515-984-6076
Mailing Address - Fax:
Practice Address - Street 1:4200 NW 98TH AVE
Practice Address - Street 2:
Practice Address - City:POLK CITY
Practice Address - State:IA
Practice Address - Zip Code:50226-2089
Practice Address - Country:US
Practice Address - Phone:515-984-6076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-12
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA18919207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine