Provider Demographics
NPI:1619920857
Name:ORPHAN, JAMES WILLIAM (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:WILLIAM
Last Name:ORPHAN
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 1:296 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:WALPOLE
Mailing Address - State:MA
Mailing Address - Zip Code:02081-3834
Mailing Address - Country:US
Mailing Address - Phone:508-668-5566
Mailing Address - Fax:508-660-1502
Practice Address - Street 1:296 MAIN STREET
Practice Address - Street 2:
Practice Address - City:WALPOLE
Practice Address - State:MA
Practice Address - Zip Code:02081-3834
Practice Address - Country:US
Practice Address - Phone:508-668-5566
Practice Address - Fax:508-660-1502
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA960111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
35068OtherHARVARD PILGRAM
4400435OtherUNITED HEALTH
721490OtherTUFTS
0037177OtherCIGNA
35068OtherHARVARD PILGRAM
4400435OtherUNITED HEALTH