Provider Demographics
NPI:1194739789
Name:SCHAFFER, JAMES H (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:H
Last Name:SCHAFFER
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 1:1125 W BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-4270
Mailing Address - Country:US
Mailing Address - Phone:484-921-4936
Mailing Address - Fax:610-917-0212
Practice Address - Street 1:509 KIMBERTON RD
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-4745
Practice Address - Country:US
Practice Address - Phone:484-921-4936
Practice Address - Fax:484-921-5413
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005948L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA569088OtherBC/BS GROUP #
TX3044930OtherAETNA PROVIDER #
PA531721OtherBS INDIVIDUAL PROVIDER #
TX0004640511OtherAETNA PIN #
PA569088OtherBC/BS GROUP #
PAU54369Medicare UPIN
PA232777873Medicare ID - Type UnspecifiedITIN
PA569088OtherBC/BS GROUP #