Provider Demographics
NPI:1477850451
Name:WASHAM, JAMES GREGORY JR (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:GREGORY
Last Name:WASHAM
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 1:2300 WALL ST
Mailing Address - Street 2:STE Q
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-2789
Mailing Address - Country:US
Mailing Address - Phone:513-531-2277
Mailing Address - Fax:513-531-2278
Practice Address - Street 1:7801 BEECHMONT AVE
Practice Address - Street 2:SUITE 16
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-4211
Practice Address - Country:US
Practice Address - Phone:513-231-4100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-28
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4189111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0052777Medicaid
OH0052777Medicaid