Provider Demographics
NPI:1548557010
Name:DR JAMES R DUPUY PC, INC
Entity Type:Organization
Organization Name:DR JAMES R DUPUY PC, INC
Other - Org Name:ALLSTAR CHIROPRACTIC AND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:DUPUY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:614-891-1800
Mailing Address - Street 1:5831 EMPORIUM SQ
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231
Mailing Address - Country:US
Mailing Address - Phone:614-891-1800
Mailing Address - Fax:
Practice Address - Street 1:5831 EMPORIUM SQ
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-2804
Practice Address - Country:US
Practice Address - Phone:614-891-1800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-06
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4030111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3017149Medicaid
OH3017149Medicaid