Provider Demographics
NPI:1417012592
Name:STEVESON, JAMES LESTER JR (DC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:LESTER
Last Name:STEVESON
Suffix:JR
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 1:107 OLDS ST
Mailing Address - Street 2:SUITE 7
Mailing Address - City:JONESVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49250-1188
Mailing Address - Country:US
Mailing Address - Phone:517-849-7230
Mailing Address - Fax:517-849-7330
Practice Address - Street 1:107 OLDS ST
Practice Address - Street 2:SUITE 7
Practice Address - City:JONESVILLE
Practice Address - State:MI
Practice Address - Zip Code:49250-1188
Practice Address - Country:US
Practice Address - Phone:517-849-7230
Practice Address - Fax:517-849-7330
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008630111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1445556674Medicaid
P00102069OtherMEDICARE RAILROAD
MI1445556674Medicaid
P00102069OtherMEDICARE RAILROAD