Basic Information
| Provider Information | |||||||||
| NPI: | 1710958012 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WEBB | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5885 SUNNYBROOK DR | ||||||||
| Address2: | SUITE E100 | ||||||||
| City: | SIOUX CITY | ||||||||
| State: | IA | ||||||||
| PostalCode: | 511064203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7122662700 | ||||||||
| FaxNumber: | 7122662759 | ||||||||
| Practice Location | |||||||||
| Address1: | 5885 SUNNYBROOK DR | ||||||||
| Address2: | SUITE E100 | ||||||||
| City: | SIOUX CITY | ||||||||
| State: | IA | ||||||||
| PostalCode: | 511064203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7122662700 | ||||||||
| FaxNumber: | 7122662759 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/27/2006 | ||||||||
| LastUpdateDate: | 07/27/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 30792 | IA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | IA00606 | 05 | IA | MEDICAID |