Provider Demographics
NPI:1780798884
Name:BIDDLE, JEFF ALLEN (DC)
Entity type:Individual
Prefix:DR
First Name:JEFF
Middle Name:ALLEN
Last Name:BIDDLE
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 1:639 GLASSPORT ELIZABETH ROAD
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:PA
Mailing Address - Zip Code:15037-1918
Mailing Address - Country:US
Mailing Address - Phone:412-384-7068
Mailing Address - Fax:412-384-2805
Practice Address - Street 1:211 PLUM ST
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:PA
Practice Address - Zip Code:15037-1517
Practice Address - Country:US
Practice Address - Phone:412-384-7068
Practice Address - Fax:412-384-2805
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002817L111NS0005X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAB1452992OtherBCBS
PAP00088766OtherRAILROAD MEDICARE
T30514Medicare UPIN
452992RDQMedicare ID - Type Unspecified