Provider Demographics
NPI:1255484754
Name:STIFFLER, JAMES G (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:G
Last Name:STIFFLER
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:PO BOX 684
Mailing Address - Street 2:
Mailing Address - City:PLUMVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16246-0684
Mailing Address - Country:US
Mailing Address - Phone:724-397-9414
Mailing Address - Fax:724-397-4927
Practice Address - Street 1:5551 ROUTE 85
Practice Address - Street 2:
Practice Address - City:HOME
Practice Address - State:PA
Practice Address - Zip Code:15747
Practice Address - Country:US
Practice Address - Phone:724-397-9414
Practice Address - Fax:724-397-4927
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003083111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1006742Medicaid
PA1006742Medicaid