Individual
MR. JAMES WESLEY ARCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1520 S LIBERTY DR, BLOOMINGTON, IN 47403-5167
(812) 676-4500
(812) 676-4501
Mailing address
PO BOX 1329, BLOOMINGTON, IN 47402-1329
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01063050A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200864430
—
IN
Enumeration date
04/11/2007
Last updated
01/07/2016
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