Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 1283 | OH |
NPI | 1356583520 |
---|---|
Provider Name | Dr. James Byran Loncar |
First Address | Mentor, OH 44060-6729 |
Second Address | Mentor, OH 44060-6729 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2009 |
Last Update Date | 23/05/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9380471 | MEDICARE GROUP PIN (01) | OH |
U80120 | (02) | OH |