Provider Demographics
NPI:1346282365
Name:SIGLOW, JAMES EDWARD (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:EDWARD
Last Name:SIGLOW
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 1:107 ROYAL BIRKDALE DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:COLUMBIANA
Mailing Address - State:OH
Mailing Address - Zip Code:44408-8493
Mailing Address - Country:US
Mailing Address - Phone:330-482-9350
Mailing Address - Fax:330-482-5695
Practice Address - Street 1:107 ROYAL BIRKDALE DR
Practice Address - Street 2:SUITE A
Practice Address - City:COLUMBIANA
Practice Address - State:OH
Practice Address - Zip Code:44408-8493
Practice Address - Country:US
Practice Address - Phone:330-482-9350
Practice Address - Fax:330-482-5695
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35058365S207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00288744OtherMEDICARE RR-GA
OH0742709Medicaid
OH942460636208OtherCARESOURCE
OHE30137Medicare UPIN
OHSI0880072Medicare ID - Type Unspecified
OH0742709Medicaid
OH0880073Medicare UPIN