Individual
JAMES E KETTELKAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4480 UTICA RIDGE RD, SUITE 2230, BETTENDORF, IA 52722-1644
(563) 742-5150
(563) 742-5175
Mailing address
4480 UTICA RIDGE RD, SUITE 2230, BETTENDORF, IA 52722-1644
(563) 742-5150
(563) 742-5175
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
31459
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110228451
RR MEDICARE
IA
05
—
1346228970
—
IA
05
—
1750347035
—
IA
05
—
3144113
—
IA
Enumeration date
01/04/2006
Last updated
02/05/2015
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