Provider Demographics
NPI:1396967808
Name:MCCOSKEY, JAMES (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:MCCOSKEY
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 1:1145 CHANNINGWAY DR.
Mailing Address - Street 2:
Mailing Address - City:FAIRBORN
Mailing Address - State:OH
Mailing Address - Zip Code:45324
Mailing Address - Country:US
Mailing Address - Phone:937-878-1071
Mailing Address - Fax:937-878-2616
Practice Address - Street 1:1145 CHANNINGWAY DR.
Practice Address - Street 2:
Practice Address - City:FAIRBORN
Practice Address - State:OH
Practice Address - Zip Code:45324
Practice Address - Country:US
Practice Address - Phone:937-878-1071
Practice Address - Fax:937-878-2616
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1581111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000210783OtherANTHEM NUMBER
OH000000210783OtherANTHEM NUMBER