Provider Demographics
NPI:1639492994
Name:JAMES B. STIEHL, MD, PC
Entity Type:Organization
Organization Name:JAMES B. STIEHL, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:B
Authorized Official - Last Name:STIEHL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:618-436-5250
Mailing Address - Street 1:1054 MARTIN LUTHER KING DR
Mailing Address - Street 2:SUITE 226
Mailing Address - City:CENTRALIA
Mailing Address - State:IL
Mailing Address - Zip Code:62801-3000
Mailing Address - Country:US
Mailing Address - Phone:618-436-5250
Mailing Address - Fax:618-436-8065
Practice Address - Street 1:1054 MARTIN LUTHER KING DR
Practice Address - Street 2:SUITE 226
Practice Address - City:CENTRALIA
Practice Address - State:IL
Practice Address - Zip Code:62801-3000
Practice Address - Country:US
Practice Address - Phone:618-436-5250
Practice Address - Fax:618-436-8065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-01
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty