Individual
JAMES T CHURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
201 S MARKET ST, OTTUMWA, IA 52501-2924
(641) 684-6896
(641) 226-5759
Mailing address
PO BOX 458, OTTUMWA, IA 52501-0458
(641) 684-6896
(641) 226-5759
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
36894
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00360614
RR MEDICARE
IA
Enumeration date
12/28/2006
Last updated
06/27/2017
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