Provider Demographics
NPI:1609092816
Name:STERN, JAMES MYRON (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MYRON
Last Name:STERN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 190
Mailing Address - Street 2:
Mailing Address - City:GILBERTSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42044-0190
Mailing Address - Country:US
Mailing Address - Phone:270-362-2308
Mailing Address - Fax:270-527-3775
Practice Address - Street 1:551 US HWY 68 WEST
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:KY
Practice Address - Zip Code:42025-0551
Practice Address - Country:US
Practice Address - Phone:606-344-0189
Practice Address - Fax:270-527-3775
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY23498208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery