Provider Demographics
NPI:1154534501
Name:DECARLO, JAMES FRANCIS (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:FRANCIS
Last Name:DECARLO
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 1:801 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:CLAIRTON
Mailing Address - State:PA
Mailing Address - Zip Code:15025-2245
Mailing Address - Country:US
Mailing Address - Phone:412-233-3600
Mailing Address - Fax:412-233-3702
Practice Address - Street 1:801 N STATE ST
Practice Address - Street 2:
Practice Address - City:CLAIRTON
Practice Address - State:PA
Practice Address - Zip Code:15025-2245
Practice Address - Country:US
Practice Address - Phone:412-233-3600
Practice Address - Fax:412-233-3702
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007246-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP01075489OtherRAILROAD MEDICARE
PA0076733240002Medicaid
PA196228OtherHIGHMARK
PA7730421OtherAETNA
PA040292ZQZ1Medicare PIN
PA196228OtherHIGHMARK