Individual
DR. AUSTIN BANCROFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1215 DUFF AVENUE, AMES, IA 50010-3014
(515) 239-4480
(515) 239-4716
Mailing address
1215 DUFF AVENUE, AMES, IA 50010-3014
(515) 239-4480
(515) 239-4716
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
02004205A
IN
207Y00000X
Otolaryngology Physician
Primary
04972
IA
207Y00000X
Otolaryngology Physician
5101017595
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
151020014
MEDICARE PTAN
IN
05
—
201162460
—
IN
Enumeration date
06/26/2008
Last updated
12/11/2020
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