Provider Demographics
NPI:1518052133
Name:HIEBERT, JAMES D (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:D
Last Name:HIEBERT
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 1:323 W BROADWAY
Mailing Address - Street 2:P O BOX 665
Mailing Address - City:PLAINVIEW
Mailing Address - State:MN
Mailing Address - Zip Code:55964
Mailing Address - Country:US
Mailing Address - Phone:507-534-2600
Mailing Address - Fax:507-534-4373
Practice Address - Street 1:323 W BROADWAY
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:MN
Practice Address - Zip Code:55964-0665
Practice Address - Country:US
Practice Address - Phone:507-534-2600
Practice Address - Fax:507-534-4373
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN966111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNU02737Medicare UPIN