Provider Demographics
NPI:1235661711
Name:SINCEBAUGH, JAMES BENJAMIN
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:BENJAMIN
Last Name:SINCEBAUGH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1270 WILLIVEE DR
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-4120
Mailing Address - Country:US
Mailing Address - Phone:585-704-4868
Mailing Address - Fax:
Practice Address - Street 1:96 JONATHAN LUCAS STREET
Practice Address - Street 2:STE 816 MSC 630
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29425-8900
Practice Address - Country:US
Practice Address - Phone:843-792-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-03
Last Update Date:2023-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN64250207R00000X
GA86605207RP1001X
SC90741207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine