Provider Demographics
NPI:1902192800
Name:STOBAUGH, JAMES (HAS, NBCHIS)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:STOBAUGH
Suffix:
Gender:M
Credentials:HAS, NBCHIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 STONE PARK LN APT 107
Mailing Address - Street 2:
Mailing Address - City:WOODLAND PARK
Mailing Address - State:CO
Mailing Address - Zip Code:80863-3175
Mailing Address - Country:US
Mailing Address - Phone:719-686-6800
Mailing Address - Fax:
Practice Address - Street 1:316 W MIDLAND AVE
Practice Address - Street 2:
Practice Address - City:WOODLAND PARK
Practice Address - State:CO
Practice Address - Zip Code:80863-3162
Practice Address - Country:US
Practice Address - Phone:719-686-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-20
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS4164237700000X
CO330237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist