Provider Demographics
NPI:1477546141
Name:PRINDLE, JOHN CURTIS (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CURTIS
Last Name:PRINDLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1375 EAST 9TH STREET
Mailing Address - Street 2:#1850
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44114
Mailing Address - Country:US
Mailing Address - Phone:216-443-0430
Mailing Address - Fax:216-443-0435
Practice Address - Street 1:26 S. WASHINGTON STREET
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13903
Practice Address - Country:US
Practice Address - Phone:607-584-0011
Practice Address - Fax:607-584-0013
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2010-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY099087207Q00000X
NY099087-1207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00435447Medicaid
NY00435447Medicaid
BB8730Medicare PIN
NYB80955Medicare UPIN