Provider Demographics
NPI:1548254998
Name:ROCHELLE, JAMES RODNEY (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:RODNEY
Last Name:ROCHELLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 MEDICAL CENTER DRIVE
Mailing Address - Street 2:SUITE 240
Mailing Address - City:NEWTON
Mailing Address - State:KS
Mailing Address - Zip Code:67114-3762
Mailing Address - Country:US
Mailing Address - Phone:316-283-9977
Mailing Address - Fax:316-283-0966
Practice Address - Street 1:800 MEDICAL CENTER DR
Practice Address - Street 2:STE 240
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114-3762
Practice Address - Country:US
Practice Address - Phone:316-283-9977
Practice Address - Fax:316-283-0966
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-31
Last Update Date:2008-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE3982207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR154474002Medicaid
AR152737001Medicaid
AR152737001Medicaid
ARA03578Medicare UPIN
AR5F017Medicare ID - Type UnspecifiedGROUP ID#