Provider Demographics
NPI:1083662878
Name:STEIN, JAMES W (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:W
Last Name:STEIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19403-6001
Mailing Address - Country:US
Mailing Address - Phone:610-630-9800
Mailing Address - Fax:610-630-9002
Practice Address - Street 1:2525 W MAIN ST
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:PA
Practice Address - Zip Code:19403-6001
Practice Address - Country:US
Practice Address - Phone:610-630-9800
Practice Address - Fax:610-630-9002
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC006422L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0861427000OtherBC/BS INDIVIDUAL
PA2016082000OtherBC/BS GRP #
PA2496174OtherAETNA PROVIDER #
PAST830329Medicare ID - Type Unspecified