1730164559 NPI number — MR. JAMES M TOON DC

Table of content: MR. JAMES M TOON DC (NPI 1730164559)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730164559 NPI number — MR. JAMES M TOON DC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TOON
Provider First Name:
JAMES
Provider Middle Name:
M
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
DC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1730164559
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/29/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 323
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BLOOMSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17815-1703
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-784-9335
Provider Business Mailing Address Fax Number:
570-784-0973

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1000 MARKET ST
Provider Second Line Business Practice Location Address:
SUITE 39
Provider Business Practice Location Address City Name:
BLOOMSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17815-2600
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-784-9335
Provider Business Practice Location Address Fax Number:
570-784-0973
Provider Enumeration Date:
12/14/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  DC009438 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3794657 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1012729840001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: T01726767 . This is a "BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1546544 . This is a "GATEWAY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1060357 . This is a "AMERICAN SPECIALTY HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2404719000 . This is a "KEYSTONE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 819140 . This is a "FIRST PRIORITY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 50051675 . This is a "BLUE CROSS" identifier . This identifiers is of the category "OTHER".




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